[垂体腺瘤患者垂体前叶激素与肿瘤大小的相关性分析]。

Y P Wang, Y J Li, B Li, L Zang, K Chen, J Du, J T Dou, Z H Lyu, W J Gu, Y M Mu
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摘要

目的:总结不同激素分泌型垂体腺瘤患者垂体前叶功能与肿瘤大小的关系。方法:回顾性病例系列研究。收集2005年1月1日至2020年12月31日在中国人民解放军总医院第一医疗中心住院的1946例垂体腺瘤患者的临床资料。采用Spearman秩相关分析分析不同类型垂体腺瘤肿瘤大小与垂体前叶激素水平的相关性。结果:1946例患者中位年龄为45.1岁,其中男性857例(44.0%)。无功能腺瘤(n=1 191)的肿瘤大小与促肾上腺皮质激素(ACTH)呈负相关(r=-0.11, Pr=-0.13, Pr=-0.26, Pr=-0.31,均Pn=297);与生长激素(r=0.46, Pr=-0.41, Pn=155)呈正相关(r=0.25, PP>0.05);催乳素瘤的肿瘤大小(n=303)与催乳素水平呈正相关(男性:r=0.34, P=0.001;女性:r=0.13, P=0.070)。结论:垂体前叶功能与肿瘤大小的关系取决于垂体腺瘤的细胞来源和分泌激素的具体类型。在生长滋长性腺瘤、垂体acth分泌腺瘤和泌乳素瘤中,肿瘤大小与相应肿瘤分泌的激素水平呈正相关。在无功能腺瘤患者中,肿瘤大小与垂体-肾上腺和垂体-生长激素轴的激素水平呈负相关。
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[Correlation analysis of anterior pituitary hormone and tumor size in patients with pituitary adenomas].

Objective: To summarize the correlation between anterior pituitary function and tumor size in patients with different hormone-secreting pituitary adenomas. Methods: This was a retrospective case series study. The clinical data of 1 946 patients with pituitary adenoma hospitalized in the First Medical Center of Chinese PLA General Hospital from January 1, 2005, to December 31, 2020, were collected. The correlation between tumor size and anterior pituitary hormone levels was analyzed using Spearman rank correlation analysis in different types of pituitary adenomas. Results: The median age of the 1 946 patients was 45.1 years, of which 857 (44.0%) were men. The maximum tumor diameter of the patients [M (Q1, Q3)] was 22 (14, 30) mm. Tumor size in nonfunctioning adenomas (n=1 191) was negatively correlated with adrenocorticotropic hormone (ACTH) (r=-0.11, P<0.001), growth hormone (r=-0.13, P<0.001), and luteinizing hormone (men: r=-0.26, P<0.001, women: r=-0.31, all P<0.001). The tumor size of somatotropic adenomas (n=297) was positively correlated with growth hormone (r=0.46, P<0.001), but negatively correlated with male testosterone (r=-0.41, P<0.001). The tumor size of ACTH-secreting pituitary adenomas (n=155) was positively correlated with the ACTH level at 8∶00 AM (r=0.25, P<0.001); however, no correlation was found with cortisol at 8∶00 AM (P>0.05). The tumor size of prolactinomas (n=303) was positively correlated with the prolactin level (men: r=0.34, P=0.001; women: r=0.13, P=0.070). Conclusions: The correlation between the function of the anterior pituitary and size of the tumor depends on the cellular origin of the pituitary adenoma and specific type of hormone secretion. In somatotroph adenomas, ACTH-secreting pituitary adenomas, and prolactinomas, there is a positive correlation between tumor size and level of hormones secreted by the corresponding tumors. In patients with nonfunctioning adenomas, the tumor size was negatively correlated with the hormone levels of the pituitary-adrenal and pituitary-growth hormone axes.

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