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目的:目的:研究侵袭性垂体腺瘤(IPA)MRI特征,探讨其最大径、体积与其侵袭性的关系;研究垂体腺瘤(PA)基质金属蛋白酶(MMP)-9、MMP-14及血管内皮生长因子(VEGF)的蛋白质表达水平与肿瘤侵袭性的相关性。方法:回顾性分析36例IPA,并以44例非侵袭性垂体腺瘤(NIPA)为对照,PA的性质由MRI表现和术中所见共同确定,所有病例术前均行MRI平扫及动态增强扫描,剂量为0.1mmol/kg。IPA的判断标准采用Knosp分级标准,3、4级视为MRI海绵窦侵袭;测量PA轴位、冠状位及矢状位的最大径,用公式(长×宽×高×1/2)计算肿瘤体积;采用SP法检测80例PA组织标本MMP-9、MMP-14及VEGF的表达,分析肿瘤的侵袭性特征与3种蛋白表达之间的相关性。结果:IPA多见于大腺瘤及巨大腺瘤,肿瘤的侵袭性与其最大径及体积呈正相关(P<0.05);IPA的MMP-9、MMP-14及VEGF的表达明显高于NIPA组(P<0.05)。结论:MRI评价IPA侵袭性的准确性较高,其诊断应综合影像学检查、术中所见及病理学检查;MMP-9、MMP-14及VEGF可作为判断IPA的良好生物学指标。
Objective: To investigate the MRI characteristics of invasive pituitary adenoma (IPA), and to explore the relationship between the maximum diameter and volume of invasive pituitary adenoma (IPA) and its invasiveness. To study the relationship between the expression of matrix metalloproteinase (MMP) -9, MMP- Correlation between protein expression of growth factor (VEGF) and tumor invasiveness. Methods: Thirty-six cases of IPA were retrospectively analyzed, and 44 non-invasive pituitary adenomas (NIPA) were used as controls. The characteristics of PA were determined by MRI and intraoperative findings. All cases underwent MRI scan and dynamic Enhanced scan at a dose of 0.1 mmol / kg. The criteria of IPA were classified according to the Knosp criteria, and the grades 3 and 4 were considered as cavernous sinus invasion. The maximum diameters of the PA axis, coronal and sagittal planes were measured. The tumor was calculated by the formula (length × width × height × 1/2) Volume. The expression of MMP-9, MMP-14 and VEGF in 80 cases of PA tissue samples were detected by SP method. The correlation between the aggressive features and the expression of three proteins was analyzed. Results: IPA was more common in large adenomas and giant adenomas. The invasiveness of the tumor was positively correlated with its maximum diameter and volume (P <0.05). The expressions of MMP-9, MMP-14 and VEGF in IPA were significantly higher than those in NIPA <0.05). Conclusions: The accuracy of MRI in evaluating the invasiveness of IPA is high. The diagnosis of IPA should be integrated with imaging examination, intraoperative findings and pathological examination. MMP-9, MMP-14 and VEGF may be used as good biological indicators for judging IPA.