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目的 探讨磁共振影像 (MRI)和分子生物学标记在评价垂体腺瘤侵袭性行为中的作用。方法 对 45例垂体腺瘤患者术前的MRI、术中所见结果和术后组织标本免疫组织化学分析结果进行研究。结果 45例垂体腺瘤中 ,MRI预测海绵窦侵袭的敏感性为 60 % ,特异性为 85 % ,阳性预测值为 83 % ,阴性预测值为 63 %。免疫组织化学分析侵袭性垂体腺瘤的微血管密度(MVD)、Ki 67标记指数、血管内皮生长因子 (VEGF)和基质金属蛋白酶 (MMP 9)表达分别为5 2 .5 2± 11.18、2 .74± 2 .83、4.73± 0 .64、3 .0 5± 1.0 4,明显高于非侵袭性垂体腺瘤的 3 4.96±18.69、1.2 5± 1.45、3 .0 9± 1.48、0 .67± 0 .74(P <0 .0 1、<0 .0 5、<0 .0 1和 <0 .0 1) ;侵袭性垂体腺瘤的抗转移基因nm 2 3表达为 1.5 5± 1.5 2 ,明显低于非侵袭性垂体腺瘤的 4.0 8± 1.18(P <0 .0 1) ;而侵袭性垂体腺瘤的原癌基因c myc标记指数和癌基因bcl 2表达分别为 1.0 7± 1.5 4、2 .3 4± 1.75与非侵袭性垂体腺瘤的 0 .3 5± 0 .73、1.66± 1.79比较无明显相关 (P >0 .0 5 )。结论 增强扫描的MRI对海绵窦侵袭性垂体腺瘤的术前判断有一定参考价值 ;MVD、Ki 67、VEGF、MMP 9和nm2 3表达与垂体腺瘤的侵袭性存在一定的关系 ,可能为侵袭性垂体腺瘤的临床治
Objective To investigate the role of magnetic resonance imaging (MRI) and molecular biology markers in the evaluation of invasive behavior of pituitary adenomas. Methods 45 cases of pituitary adenoma preoperative MRI, intraoperative findings and postoperative histological immunohistochemical analysis results were studied. Results In 45 cases of pituitary adenomas, the sensitivity and specificity of MRI in predicting the invasion of cavernous sinus were 60%, 85%, 83% and 63%, respectively. The expression of MVD, Ki67, VEGF and MMP 9 in invasive pituitary adenomas were 52.2 ± 11.18 and 2.74 respectively by immunohistochemistry ± 2.83,4.73 ± 0.64,3.0 ± 1.04, which was significantly higher than that of noninvasive pituitary adenomas3 4.96 ± 18.69,1.25 ± 1.45,3.0 9 ± 1.48,0.67 ± 0.74 (P <0.01, <0.05, <0.01 and <0.01). The expression of anti-metastasis gene nm 2 3 in invasive pituitary adenomas was 1.5 5 ± 1.5 2, Which was significantly lower than that of non-invasive pituitary adenomas (4.08 ± 1.18, P <0.01). The expressions of c-myc and oncogene bcl-2 in invasive pituitary adenomas were 1.07 ± 1.54 , 23.4 ± 1.75 and non-invasive pituitary adenomas 0. 35 ± 0.73,1.66 ± 1.79 no significant correlation (P> 0.05). Conclusions Enhanced MRI can be helpful to the preoperative evaluation of cavernous sinus invasion of pituitary adenoma. The expressions of MVD, Ki 67, VEGF, MMP 9 and nm23 are related to the invasiveness of pituitary adenoma, which may be invasive Clinical treatment of pituitary adenoma