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目的探索MRI和分子生物学标志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化分析结果进行前瞻性研究。结果MRI预测海绵窦侵袭的敏感性60％，特异性85％，阳性预测值83％，阴性预测值63％；免疫组化分析侵袭性垂体腺瘤的MvD、Ki-67标记指数、VEGF和MMP-9表达明显高于非侵袭性垂体腺瘤(统计学分析P值分别为：<0．001、=0．039、<0．001和<0．001)；但侵袭性垂体腺瘤的nm23表达却明显低于非侵袭性垂体腺瘤(P<0．001)；另外，统计学分析c-myc标记指数和Bcl-2表达与垂体腺瘤的侵袭性无关(P=0．061和P=0．201)。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标记指数、VEFG、MMP-9和nm23表达与垂体腺瘤的侵袭性有关。
Objective To explore the role of MRI and molecular biology markers in assessing invasive behavior of pituitary adenomas. Methods 45 cases of pituitary adenoma preoperative MRI, intraoperative findings and postoperative tissue immunohistochemical analysis of the results of a prospective study. Results The sensitivity, specificity and accuracy of MRI in predicting cavernous sinus invasion were 60%, 85%, 83% and 63%, respectively. The MvD, Ki-67 labeling index, VEGF and MMP of invasive pituitary adenomas -9 was significantly higher than that of non-invasive pituitary adenomas (P <0.001, = 0.039, <0.001 and <0.001, respectively) (P <0.001). In addition, statistical analysis showed that c-myc labeling index and Bcl-2 expression were not associated with the invasiveness of pituitary adenomas (P = 0.061 and P = 0.201). Conclusions Enhanced MRI can be useful for preoperative evaluation of cavernous sinus invasion of pituitary adenoma. The expression of MVD, Ki-67, VEFG, MMP-9 and nm23 are related to the invasiveness of pituitary adenoma.