| OBJECTIVE This retrospective analysis is aimed to investigate and discussion the clinical history ?image characteristic of pituitary adenoma with hypopituitarism.METHODS A total of 127 cases of pituitary adenoma with hypopituitarism from 2014 to 2017,were diagnosed in first ward of neurosurgery in the first affiliated hospital of Guangxi medical university.The clinical history ? image characteristic of pituitary adenoma with hypopituitarism ?immunohistochemical were investigated and discussed.RESULTS Among the 127 patients,64 were males and 63 were females.Age ranges from 17 to 77,with an average of 46.3 years.The patient had a minimum of 3 days,with a maximum of 20 years and an average of 25.5 months.Clinical manifestation: has a history of pituitary tumor surgery of 17 cases(13.4%),accident detection,8 cases(6.3%),35 cases(27.6%),headache,dizziness,18 cases(14.2%),decreased vision 60 cases(47.2%),3 cases(2.4%),visual field loss was blind in 1 case(0.8%),amenorrhoea 21 cases(16.5%),lactation 8 cases(6.3%),6 cases of menstrual disorder(4.7%),sexual function decline in 3 cases(2.4%),Marie 9 cases(7.1%),vomiting in 5 cases(3.2%),weakness in 1 case(0.8%).Imaging characteristics: according to the imaging of pituitary adenoma Knosp classification in classification,divided into greater than or equal to 3 81 cases(63.78%),less than 3 levels of 46 cases(36.22%),according to the maximum diameter to the saddle tumors can be divided into,greater than or equal to 3 cm of 41 cases(32.28%),86 cases(67.72%)less than 3 cm,imaging in 62 cases of cystic change(48.82%),65 cases(51.18%)without cystic change.Biochemical detection: electrolyte: the blood sodium was lower than the normal 19 cases(14.96%),the blood potassium was lower than the normal 12 cases(9.45%),the blood chlorine was lower than the normal 3 cases(2.3%),and the blood calcium was lower than the normal 5 cases(3.94%).Blood lipid,serum triglycerides(TG)is higher than normal 34 cases(50%),serum total cholesterol(TC)is higher than normal 33 cases(48.53%),serum high density lipoprotein cholesterol(HDL-C)below normal 53 cases(77.94%),serum levels of low-density lipoprotein cholesterol(LDL-C)above normal 27 cases(39.71%),fasting glucose levels lower than normal blood of 7 cases(5.6%).Endocrine gland detection: thyroid axis hormones decline in 76 patients(59.84%),gonad axis hormone decline in 114 patients(89.76%),decreased prolactin axis in 12 cases(9.45%),growth hormone axis hormone decline in 1 case(0.79%),and to promote the hormone cortisol axis hormone decline in 86 patients(67.72%).In the postoperative pathological immunohistochemistry,97 cases(76.38%)and 30 cases(23.62%)were positive in ki-67 expression.Single factor analysis of statistics showed that the expression of Ki-67,serum total cholesterol(TC),fasting blood glucose,serum T3,T4,FT3,FT4,PROG with imaging Knosp grading was statistically associated(P values were 0.002,0.083,0.000,0.054,0.005,0.004,0.005,0.004);Ki-67,serum potassium,triglyceride(TG),T4,GH and imaging were statistically correlated with the largest diameter(P value was 0.008,0.091,0.010,0.047,0.064).Further correction after multiariable Logistic regression analysis,only the postoperative pathological expression of Ki-67 with imaging Knosp grading was statistically significant(OR: 0.00,95% CI: 0.00 0.54,P: 0.006),TG and imaging saddle growth diameter was statistically significant(OR: 0.566,95% CI: 0.358 0.893,P: 0.015).CONCLUSION 1?Pituitary adenomas with hypopituitarism have the most effect on the sex hormone axis;2?The higher the Knosp classification,the higher the expression rate of ki-67 in pituitary adenoma with hypopituitarism 3?TG is rise common in pituitary adenoma with hypopituitarism growing in the saddle. |
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