摘要
目的分析经蝶窦入路手术治疗库欣病的结局及评估用Knosp分级判断库欣病肿瘤侵袭性的效果。方法回顾1978至2017年就诊于北京协和医院神经外科的库欣病病例。以术中所见肿瘤是否具有侵袭性作为"金标准",分析用Knosp分级判断肿瘤侵袭性的灵敏度和特异度。结果库欣病患者共1061例,其中83例(7.82%)在手术中确认发生海绵窦侵袭,44例(53.0%)在末次随访时保持着缓解。Knosp分级判断库欣病肿瘤侵袭性的灵敏度为47.0%、特异度为91.1%,其阳性预测值为31.0%、阴性预测值为95.3%。结论经蝶窦入路手术治疗侵袭性垂体腺瘤的库欣病的长期缓解率相对较低。由Knosp分级为0~2级而判断肿瘤不具有侵袭性比较可靠。当Knosp分级为3~4级时,对肿瘤是否发生侵袭需存疑。
Objective To review the outcomes in patients with Cushing's disease (CD) after transsphenoidal surgery (TSS) and to assess the performance of Knosp grade for cavernous sinus invasion (CSI). Methods Medical records were reviewed for patients with CD undergoing TSS from 1978 to 2017 at Peking Union Medical College Hospital. Based on whether CSI was observed during surgery, the sensitivity and specificity of Knosp grade for CSI were evaluated. Results There were 1 061 records of CD reviewed, 83 (7.82%) of which were invasive tumors evaluated by surgery, and 44 (53.0%) of these remained in endocrinological remission at the last follow-up. The sensitivity of Knosp grade for CSI was 47.0%, and the specificity was 91.1%;besides, the positive predictive value was 31.0%, and the negative predictive value was 95.3%. Conclusions Initial TSS for CD with invasive adenomas is of relatively low remission rate. Knosp grade 0-2 for non-invasive tumors is reliable, while it is doubtful whether or not Knosp grade 3-4 indicates invasive tumor.
作者
徐学友
王任直
Xu Xueyou;Wang Renzhi(Department of Neurosurgery,the Affiliated Hopital of Guizhou Medical University,Guiyang 550004, China;Department of Neurosurgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2019年第5期388-390,共3页
National Medical Journal of China
关键词
库欣病
海绵窦侵袭
Knosp分级
效果
Cushing′s disease
Cavernous sinus invasion
Knosp grade
Performance
