论文部分内容阅读
目的通过对GH瘤、PRL瘤和ACTH瘤等垂体激素水平的测定与术后病理免疫组化指标的一致性分析,对术前的临床诊断进行评估。方法对所有患者在手术前影像学检测及垂体激素水平的测定,将术前具有典型临床表现、影像特征和血清检查中显示的激素水平作为临床诊断,术后病理免疫组化指标作为病理诊断。采用SPSS 20.0统计软件的交叉表分析工具进行三种激素的临床与免疫组化诊断的一致性分析。通过Kappa值判断两种诊断方法的一致性。结果 GH瘤临床与病理诊断的一致性Kappa值=0.431,PRL瘤临床与病理诊断的一致性Kappa值=0.543,ACTH瘤临床与病理诊断的一致性Kappa值=0.418。Kappa值均大于0.4,表明三种内分泌激素瘤临床与病理诊断具有一致性;p=0.00,说明一致性具有统计学意义。结论垂体激素水平的测定有助于垂体瘤的临床诊断及手术方式的选择,并可以作为术后疗效的判定。患者术后进行免疫组化病理检查,可以减少漏诊或误诊率,使垂体瘤的临床与病理诊断保持一致性,并改善预后。
OBJECTIVE: To evaluate the preoperative clinical diagnosis of GH tumors, PRL tumors and ACTH tumors and other pituitary hormone levels and histopathological immunohistochemical analysis of consistency. Methods The preoperative imaging and pituitary hormone levels were measured in all patients. The typical clinical manifestations, imaging features and hormone levels in serum examination before operation were regarded as clinical diagnosis. Postoperative pathological immunohistochemical indexes were used as pathological diagnosis. Crosstab analysis tools of SPSS 20.0 statistical software were used to analyze the consistency of clinical and immunohistochemical diagnosis of the three hormones. Kappa value to determine the consistency of the two diagnostic methods. Results The consistent Kappa value of clinical and pathological diagnosis of GH tumor was 0.431, the consistency of clinical and pathological diagnosis of PRL tumor was 0.543, and the consistency Kappa value of clinical and pathological diagnosis of ACTH tumor was 0.418. Kappa values were greater than 0.4, indicating that the three clinical and pathological diagnosis of endocrine hormone tumors consistent; p = 0.00, indicating that the consistency was statistically significant. Conclusion The determination of pituitary hormone levels is helpful for the clinical diagnosis of pituitary tumor and the selection of surgical methods, and can be used as the judgment of the curative effect. Postoperative immunohistochemical histopathological examination of patients can reduce the missed diagnosis or misdiagnosis rate, the clinical and pathological diagnosis of pituitary tumor to maintain consistency and improve prognosis.