摘要
背景垂体瘤卒中发病急、症状严重、病情进展快,其发病率为10%~15%,且近年呈升高趋势,但是针对其发生发展机制的研究尚处于起步阶段,且分子机制尚未明确;另外,头痛虽是垂体瘤的常见症状,但并非发生于所有患者,其分子机制也尚未明确。目的探讨血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP)-9、MMP-2与垂体瘤卒中及垂体瘤头痛的关系,以为临床诊疗提供参考。方法选取2010年1月—2018年5月在安康市中心医院进行手术治疗的100例垂体瘤患者的病理组织标本,其中出现头痛67例,未出现头痛33例。根据垂体瘤卒中发生情况分为观察组(发生垂体瘤卒中)和对照组(未发生垂体瘤卒中),各50例。比较观察组与对照组及头痛、非头痛的垂体瘤患者VEGF、MMP-9、MMP-2的免疫反应评分(IRS)。采用Spearman秩相关分析探讨垂体瘤卒中及垂体瘤头痛患者VEGF、MMP-9、MMP-2的IRS之间的相关性;绘制受试者工作特征曲线(ROC曲线)以分析VEGF、MMP-9、MMP-2的IRS对垂体瘤卒中的预测价值。结果观察组VEGF、MMP-9、MMP-2的IRS均高于对照组(P<0.05)。Spearman秩相关分析结果显示,垂体瘤卒中患者VEGF的IRS与MMP-9、MMP-2的IRS均呈正相关(rs值分别为0.433、0.319,P值均<0.05),MMP-9的IRS与MMP-2的IRS呈正相关(rs=0.471,P<0.05)。ROC曲线分析结果显示,VEGF、MMP-9、MMP-2的IRS预测垂体瘤卒中的曲线下面积(AUC)分别为0.839〔95%CI(0.754,0.924)〕、0.954〔95%CI(0.914,0.993)〕、0.918〔95%CI(0.862,0.973)〕。MMP-9的IRS预测垂体瘤卒中的AUC大于VEGF的IRS(Z=2.672,P=0.008)。头痛的垂体瘤患者VEGF、MMP-9的IRS均高于非头痛的垂体瘤患者(P<0.05)。Spearman秩相关分析结果显示,垂体瘤头痛患者VEGF的IRS与MMP-9、MMP-2的IRS均呈正相关(rs值分别为0.528、0.393,P值均<0.05),MMP-9的IRS与MMP-2的IRS呈正相关(rs=0.603,P<0.05)。结论VEGF与MMP-9、MMP-2可能协同参与了垂体瘤卒中的发生过程,抗VEGF治�
Background Pituitary apoplexy is characterized as acute onset,severe symptoms,rapid progress,and its incidence rate which has been increasing in recent years is 10%-15%.However,the research on its mechanism of occurrence and development is still in infancy and its molecular mechanism is not yet clear.In addition,although headache is a common symptom of pituitary tumor,it does not occur in all patients,and its molecular mechanism is not clear either.Objective To investigate the relationships between vascular endothelial growth factor(VEGF),matrix metalloproteinase(MMP)-9,MMP-2 and pituitary apoplexy and pituitary tumor headache,so as to provide reference for clinical diagnosis and treatment.Methods Pathological tissue specimens of 100 patients with pituitary tumor underwent surgery in Ankang Central Hospital from January 2010 to May 2018 were collected,and there were 67 patients with headache and 33 patients without headache.According to the incidence of pituitary apoplexy,they were divided into observation group and control group,with 50 cases in each group.The immune response score(IRS)of VEGF,MMP-9 and MMP-2 in observation group and control group and the patients with or without pituitary tumor headache were compared.The correlations among IRS of VEGF,MMP-9 and MMP-2 in patients with pituitary apoplexy and pituitary tumor headache were respectively analyzed according to Spearman rank correlation analysis,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive values of IRS of VEGF,MMP-9 and MMP-2 for pituitary apoplexy.Results The IRS of VEGF,MMP-9 and MMP-2 in observation group were significantly higher than those in control group(P<0.05).Spearman rank correlation analysis showed that,the IRS of VEGF in patients with pituitary apoplexy was positively correlated with that of MMP-9 and MMP-2(rs value was 0.433,0.319,respectively,P<0.05),and there was also positive correlation between the IRS of MMP-9 and that of MMP-2(rs=0.471,P<0.05).ROC curve analysis results showed that,the are
作者
金涛
周跃飞
王晰
杨西爱
陈鹤鸣
JIN Tao;ZHOU Yuefei;WANG Xi;YANG Xiai;CHEN Heming(Department of Neurosurgery,Ankang Central Hospital,Ankang 725000,China;Department of Neurosurgery,Xijing Hospital of the Fourth Military Medical University,Xi'an 710000,China;Department of Pathology,Ankang Central Hospital,Ankang 725000,China;Department of Neurology,Ankang Central Hospital,Ankang 725000,China;Department of Endocrinology,Ankang Central Hospital,Ankang 725000,China)
出处
《实用心脑肺血管病杂志》
2021年第3期52-57,67,共7页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
陕西省重点研发计划一般项目—社会发展领域(2017SF-219)。
关键词
垂体瘤
垂体瘤卒中
头痛
血管内皮生长因子
基质金属蛋白酶
Pituitary tumor
Pituitary apoplexy
Headache
Vascular endothelial growth factors
Matrix metalloproteinase
