摘要
目的 探讨儿童垂体腺瘤的临床特点及治疗方法。方法 回顾性分析河南省人民医院在2001年1月至2015年1月收治的24例垂体腺瘤患儿，分析其年龄、性别、临床症状、肿瘤分型、治疗及预后等情况。随访垂体相关激素及磁共振成像。结果 本组患儿中位年龄16.2岁（6.0～17.8岁）；男女比例为1∶3；常见临床症状包括内分泌相关症状18例，视野缺损8例等；其中泌乳素腺瘤12例（50.0%），促皮质素腺瘤4例（16.7%），生长激素腺瘤3例（12.5%），多激素腺瘤3例（12.5%），无功能腺瘤2例（8.4%）；微、小腺瘤与大腺瘤之比为15∶9，无巨大腺瘤；经鼻手术14例（58.3%），经翼点手术5例（20.8%），经眶锁孔手术2例（8.3%），经额下手术1例（4.2%），完全药物治疗2例（8.3%）；22例手术患儿中，全切18例，次全切4例；随访（5.7±2.5）年（2～10年），全切的18例中，6例在2年内复发，次全切的4例在2年内均有不同程度生长。接受伽马刀治疗的患儿出现发育障碍4例（4/7例），未接受伽马刀治疗患儿出现发育障碍7例（7/17例），二者比较差异有统计学意义（P＝0.002）。结论 儿童垂体腺瘤以女性多见，内分泌相关症状最为常见，泌乳素腺瘤是最常见亚型，术后复发率较高，应根据患儿情况实行个体化治疗。但无论何种方式的放射治疗，包括伽马刀治疗，造成的可能的发育障碍应引起高度重视。
Objective To explore the clinical manifestations and treatment of pediatric pituitary adenoma.Methods Between January 2001 to January 2015, 24 pediatric patients diagnosed with pituitary adenoma were treated in People′s Hospital of Henan Province.The clinical data were retrospectively analyzed, including age, gender, clinical manifestation, therapy and prognosis.Endocrinological levels including all pituitrin and magnetic resonance imaging were analyzed by the follow-up survey.Results The median age was 16.2 years old, ranged from 6.0 to 17.8 years old.Common clinical manifestations were comprised of endocrine-related symptoms （18 cases） and visual deficit （8 cases）, and so on.The ratio of male to female was 1∶3.There were 12 cases of prolactin （PRL）-secreting adenoma（50.0%）, 4 cases of adrenocorticotropic hormone-secreting adenoma （16.7%）, 3 cases of growth hormone-secreting adenoma （12.5%）, 3 cases of plurihorminal adenomas （12.5%）, and 2 cases of non-functioningadenomas（8.4%）. The ratio of micro-adenoma versus macro-adenoma was 15∶9, and there was no invasive macro-adenoma.Transsphenoidal surgery was applied in 14 cases （58.3%） with respect to 2 cases （8.3%） in transorbital keyhole approach, 5 cases （20.8%） through pterional approach, and still 1 case （4.2%） through transsubfrontal approach.Two cases（8.3%） were cured with medications.Eighteen cases were totally resected, while 4 cases were subtotal resected.Six of 18 gross total resection patients recurred within 2 years, while tumors of subtotal resection grew differently.Hypotrophy in patients who received Gamma knife therapy （4/7 cases） was statistically different than that in the patients who did not （7/17 cases） （P=0.002）.Conclusion Pediatric pituitary adenomas are usually common in female with endocrine related symptoms, and PRL-secreting adenoma is the most common subtype, and recurrence rate was higher.Individualized therapy is needed for the invalid cases.But any radiotherapy including Gamma knife therapy might induce hypotrophy, which requires special attention.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2017年第18期1429-1432,共4页
Chinese Journal of Applied Clinical Pediatrics
关键词
垂体腺瘤
临床特点
治疗
儿童
Pituitary adenoma
Clinical manifestation
Treatment
Child
