论文部分内容阅读
目的对垂体瘤质地进行多因素相关性分析,指导垂体瘤质地的术前评估和手术入路选择。方法连续搜集73例垂体瘤病人的临床、影像及手术资料,术前测定患者MRI T2加权像上的瘤体与白质信号比。依术中所见将肿瘤质地分为两种类型:质地软(50例)、质地硬(23例)。采用天狼猩红染色法检测肿瘤胶原含量,并以免疫组化方法检测不同质地垂体腺瘤中的TGF-β1和TIMP1的表达。结果质地硬与质地软组中:①垂体腺瘤质地与患者的临床特性如性别、大小和肿瘤类型无明显关系,与生长方式有关;②瘤体与白质信号比分别为:1.0684±0.2039和2.20341±0.36075;胶原含量分别为(:29.388±14.772)%、(8±2.475)%,两者差异显著(P<0.01),且胶原含量与信号强度比值呈明显负相关(r=-0.787,P<0.05);③TGF-β1表达量分别为:0.62±0.23和0.28±0.4,TIMP1表达量分别为0.53±0.15、0.25±0.17,二者表达均与胶原含量呈正相关(r=0.781,r=0.46,P<0.01)。结论垂体腺瘤质地变硬的显著病理特征是胶原过度沉积,T2加权像上的瘤体与白质信号比与肿瘤功能分类及肿瘤生长方式相结合可以术前预测垂体瘤质地。TGF-β1和TIMP1可能在垂体腺瘤质地变化中起重要作用。
Objective To analyze the multivariate correlation of the pituitary tumor and guide the preoperative evaluation and surgical approach of the pituitary tumor. Methods The clinical, imaging and surgical data of 73 patients with pituitary adenoma were collected continuously. The ratio of tumor to white matter on MRI T2 weighted images of patients was measured preoperatively. According to the findings of the surgery will be divided into two types of tumor texture: soft texture (50 cases), texture hard (23 cases). Tissue collagen content was detected by Sirius red staining, and the expression of TGF-β1 and TIMP1 in pituitary adenomas with different texture was detected by immunohistochemistry. Results Hard texture and texture soft tissue: ① pituitary adenoma texture and clinical characteristics of patients such as gender, size and type of tumor no significant relationship with the growth pattern; ② tumor and white matter signal ratio were: 1.0684 ± 0.2039 and 2.20341 ± 0.36075, collagen content was (29.388 ± 14.772)% and (8 ± 2.475)% respectively, there was significant difference between the two groups (P <0.01), and the collagen content was negatively correlated with the signal intensity ratio <0.05). The expression of TGF-β1 was 0.62 ± 0.23 and 0.28 ± 0.4 respectively, the expression of TIMP1 was 0.53 ± 0.15 and 0.25 ± 0.17, respectively. The expression of TGF-β1 was positively correlated with collagen content (r = 0.781, r = 0.46 , P <0.01). Conclusions The pathological features of pituitary adenomas harden are collagen hyperplasia. The signal intensity ratio of tumor to white matter on T2 weighted images can be used to predict pituitary tumor preoperatively in combination with tumor function classification and tumor growth pattern. TGF-β1 and TIMP1 may play an important role in the changes of pituitary adenoma texture.