Studies On The Correlation Betweenimmumohistochemical Stainingmethod,Hormone Levels And Clinical Signs Of Pituitary Adenoma

Objective:The results of pathological immunohistochemical staining in patients with pituitary tumor were retrospectively analyzed and their correlation with preoperative hormone levels and clinical symptoms was analyzed.Methods:(1)Collected from January 2011 to December 2016 in affiliated hospital of Qingdao university of surgical treatment of 189 patients with pituitary adenoma,both preoperative imaging studies,all relevant pituitary hormone determination,postoperative pathological immunohistochemical staining.(2)The results include basic information,clinical symptoms,preoperative pituitary hormone levels,imaging findings,and pathological immunohistochemical staining.(3)The correlation between immunohistochemical staining of pituitary adenoma with Kappa and Spearman was used to analyze the corresponding hormone levels and clinical symptoms in serum.Results:(1)In 189 Pituitary adenomas,there were 74 men and 115 women.There were 26 PRL secreting adenoma,15 GH secreting adenoma,9 ACTH secreting adenoma,44 Gn H secreting adenoma,2 TSH secreting adenoma,55 Polyhormone adenoma,38 NFPA.There were 8 cases of microadenomas,148 large adenomas and 15 cases of giant adenomas.All pituitary adenomas and patients with GH and no functional adenoma were significantly more women than men,with statistically significant differences(all P< 0.05).However,there was no statistically significant difference between ACTH tumor,PRL tumor,FSH tumor,TSH tumor and multihormone adenoma(P>0.05).(2)The age range was 17~76 years old,with an average age of 47.97 plus or minus 12.13 years.The age distribution of 60.8% is between 40 and 60 years old.The age of adenoma of pituitary adenoma was different,and the age of the patients with Gn H tumor and non-functional adenoma was greater than PRL and GH tumor,and the differences were statistically significant(all P< 0.05).(3)Gn H tumor diameter is greater than GH tumor,ACTH tumor,multihormone adenoma.No functional adenoma tumor diameter was greater than GH tumor,ACTH tumor diameter.In all pituitary adenomas and non-functional adenomas,the male tumor was larger than the female,and the difference was statistically significant(all P< 0.05).The tumor diameter of female nonfunctional adenoma was greater than that of GH tumor,ACTH tumor and Gn H tumor.The tumor diameter of female Gn H tumor wasgreater than that of ACTH tumor and multihormone adenoma tumor,and the difference was statistically significant(all P< 0.05).There was no statistically significant difference in tumor diameter between the other groups and between the male groups(all P> 0 0.05).(4)Regarding serum PRL>100ng/ml as clinical diagnostic criteria,the coincidence rate and Kappa coefficient were highest,81.9% and 0.517.Line type to tumble into two groups as the gold standard,serum PRL ROC curve,found that when the serum levels of 69.785 ng/ml as a diagnostic standard,the area under the curve,the largest sensitivity 49.1%,specificity of 98.2%,clinical diagnosis and pathological diagnosis coincidence rate is highest.Serum prolactin(prl)level in PRL tumor is moderate positive correlation with tumor size(r=0.530).(5)The conformance rate of immunohistochemical staining was 85.5 percent and the Kappa coefficient was 0.688,indicating the consistency of the two diagnoses.Serum GH level in GH tumor is moderate positive correlation with tumor size(r = 0.629)was associated with moderate negative correlation(r=-0.715).(6)The conformance rate and Kappa coefficient of immunohistochemical staining in immunohistochemistry of multihormone adenomas were 78.9%,0.465,and the two diagnoses were of good consistency.(7)In this study,the concomitations of ACTH,Gn H,TSH,and non-functional adenomas were 75%,66.4%,89.6% and 42.1%,respectively,respectively,in the diagnosis of serological diagnosis and postoperative immunohistochemistry.The Kappa coefficients of the two diagnoses were 0.075,0.159,0.157 and 0.103 respectively,indicating that all of them were consistent and inconsistent.Conclusions:(1)The most common adenomas of pituitary adenomas were polygonadomas,followed by Gn H tumors and PRL tumors.(2)Pituitary adenomas are mainly female and large adenomas,with a good age of 40 to 60 years.(3)The serum PRL level was moderately positive with tumor size.Serum GH levels were positively correlated with tumor size and moderate positive correlation with age.(4)The diagnosis of pituitary adenoma is consistent with pathological immunohistochemistry diagnosis,and the consistency of GH tumor and PRL tumor is the highest.