目的:研究神经内镜及显微镜单鼻孔蝶窦入路垂体瘤切除术的疗效及对预后和血清学指标的影响。方法:选取本院收治的120例垂体瘤患者,随机分为观察组和对照组各60例。观察组采用神经内镜下单鼻孔蝶窦入路垂体瘤切除治疗,对照组采用显微镜...目的:研究神经内镜及显微镜单鼻孔蝶窦入路垂体瘤切除术的疗效及对预后和血清学指标的影响。方法:选取本院收治的120例垂体瘤患者,随机分为观察组和对照组各60例。观察组采用神经内镜下单鼻孔蝶窦入路垂体瘤切除治疗,对照组采用显微镜下切除治疗。比较两组手术对临床疗效、并发症、预后的影响,以及对激素水平、视觉功能等的改善情况。结果:观察组全切率显著高于对照组,复发率、术中出血量、手术时间以及术后住院时间显著低于对照组,差异有统计学意义( P <0.05)。术后2周两组促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、促甲状腺素(thyroid stimulating hormone,TSH)以及生长激素(human growth hormone,HGH)水平均显著下降,其中术后2周观察组各激素水平显著低于对照组( P <0.05)。术中两组去甲肾上腺素(norepinephrine,NE)、肾上腺素(epinephrine,E)、血管紧张素(angiotensin,ATⅡ)、肾素(renin,R)水平均显著增加,术中观察组各应激指标水平显著低于对照组( P <0.05)。术后2周两组视野指数(VFI)、模式标准差(PSD)、平均缺损(MD)较术前变化显著,其中观察组术后2周MD、VFI显著高于对照组,PSD、显著低于对照组( P <0.05)。主要并发症为脑脊液漏、尿崩、颅内出血以及感染,观察组总发生率显著低于对照组( P < 0.05)。结论:神经内镜下单经鼻孔蝶窦入路垂体瘤切除术疗效显著优于显微镜手术,神经内镜手术可显著减少术中出血量和降低应激反应,从而降低并发症发生率,有利于预后。展开更多
Pituitary adenomas（PAs） are well known as a common intracranial benign tumor, and a portion of PAs are refractory to current therapeutic methods. Erb B receptors family signaling pathway regulates the expression of ...Pituitary adenomas（PAs） are well known as a common intracranial benign tumor, and a portion of PAs are refractory to current therapeutic methods. Erb B receptors family signaling pathway regulates the expression of PAs activation associated gene. Inhibition of epidermal growth factor receptor（EGFR） can inhibit proliferation of PAs. Leucine-rich repeats and immunoglobulin-like domains protein 1（ LRIG1）, a negative mediated gene of Erb B receptors family, plays a role in many tumors. However, there are seldom researches about the functional role of LRIG1 in PAs. The aim of this study is to explore the potential effect of LRIG1 and its regulating mechanism in PAs. First, we investigated the role of LRIG1 in cell migration, invasion of PAs with transfected LRIG1 or control. Then, we explored its impact on cell proliferation and apoptosis of PAs in vivo. To study the regulating mechanism of LRIG1, we examined the expression of molecular factor of PI3K/AKT and Ras/Raf/ERK pathway using Western blotting in vitro and RT-PCR in vitro and in vivo. It was found that LRIG1 over-expression inhibited cell migration, invasion and proliferation, and promoted apoptosis of PAs in vivo and in vitro. Furthermore, LRIG1 suppressed the expression of signaling of PI3K/AKT and Ras/Raf/ERK pathways in PAs. LRIG1, as a negative mediated gene of tumor, can inhibit biological function of PAs via inhibiting PI3K/AKT and Ras/Raf/ERK pathways, and it might be a new target for gene therapy of PAs.展开更多
文摘目的:研究神经内镜及显微镜单鼻孔蝶窦入路垂体瘤切除术的疗效及对预后和血清学指标的影响。方法:选取本院收治的120例垂体瘤患者,随机分为观察组和对照组各60例。观察组采用神经内镜下单鼻孔蝶窦入路垂体瘤切除治疗,对照组采用显微镜下切除治疗。比较两组手术对临床疗效、并发症、预后的影响,以及对激素水平、视觉功能等的改善情况。结果:观察组全切率显著高于对照组,复发率、术中出血量、手术时间以及术后住院时间显著低于对照组,差异有统计学意义( P <0.05)。术后2周两组促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、促甲状腺素(thyroid stimulating hormone,TSH)以及生长激素(human growth hormone,HGH)水平均显著下降,其中术后2周观察组各激素水平显著低于对照组( P <0.05)。术中两组去甲肾上腺素(norepinephrine,NE)、肾上腺素(epinephrine,E)、血管紧张素(angiotensin,ATⅡ)、肾素(renin,R)水平均显著增加,术中观察组各应激指标水平显著低于对照组( P <0.05)。术后2周两组视野指数(VFI)、模式标准差(PSD)、平均缺损(MD)较术前变化显著,其中观察组术后2周MD、VFI显著高于对照组,PSD、显著低于对照组( P <0.05)。主要并发症为脑脊液漏、尿崩、颅内出血以及感染,观察组总发生率显著低于对照组( P < 0.05)。结论:神经内镜下单经鼻孔蝶窦入路垂体瘤切除术疗效显著优于显微镜手术,神经内镜手术可显著减少术中出血量和降低应激反应,从而降低并发症发生率,有利于预后。
基金supported by grants from the National Natural Science Foundation of China(No.81560412)Jiangxi Provincial Health Development Planning Commission Project(No.20141065)Jiangxi Provincial Natural Science Foundation of China(No.20152BCB24009 and No.20151BDH80009)
文摘Pituitary adenomas（PAs） are well known as a common intracranial benign tumor, and a portion of PAs are refractory to current therapeutic methods. Erb B receptors family signaling pathway regulates the expression of PAs activation associated gene. Inhibition of epidermal growth factor receptor（EGFR） can inhibit proliferation of PAs. Leucine-rich repeats and immunoglobulin-like domains protein 1（ LRIG1）, a negative mediated gene of Erb B receptors family, plays a role in many tumors. However, there are seldom researches about the functional role of LRIG1 in PAs. The aim of this study is to explore the potential effect of LRIG1 and its regulating mechanism in PAs. First, we investigated the role of LRIG1 in cell migration, invasion of PAs with transfected LRIG1 or control. Then, we explored its impact on cell proliferation and apoptosis of PAs in vivo. To study the regulating mechanism of LRIG1, we examined the expression of molecular factor of PI3K/AKT and Ras/Raf/ERK pathway using Western blotting in vitro and RT-PCR in vitro and in vivo. It was found that LRIG1 over-expression inhibited cell migration, invasion and proliferation, and promoted apoptosis of PAs in vivo and in vitro. Furthermore, LRIG1 suppressed the expression of signaling of PI3K/AKT and Ras/Raf/ERK pathways in PAs. LRIG1, as a negative mediated gene of tumor, can inhibit biological function of PAs via inhibiting PI3K/AKT and Ras/Raf/ERK pathways, and it might be a new target for gene therapy of PAs.
