Clinical study of pituitary tumors with EEA resection and its influence on the expression of tumor necrosis factor-α, interleukin-6, and interleukin-12 in patients

Abstract

The aim of this study is to investigate the efficacy of expanded endonasal approaches (EEAs) in the treatment of pituitary adenoma, and the effects of serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-12 (IL-12) in patients were further analyzed. A total of 80 cases of patients with pituitary adenoma admitted to our hospital from January 2013 to May 2015 were randomly divided into the observation group and control group, with 40 cases in each group. The observation group was treated with EEA technique, while the control group was treated with transcranial microsurgery. The prolactin (PRL), growth hormone (GH) and other endocrine hormone indexes, as well as inflammatory factors such as TNF-α, IL-6, and IL-12 were compared before and 1 week after the operation between the two groups. Moreover, the scores of Karnofsky performance status (KPS) and Mini-Mental State Examination (MMSE) at preoperative and postoperative 1 week were also compared between the two groups. The operation time, hospitalization time, and postoperative complications were compared between the two groups. And the patients were followed up for 2 years to observe the recurrence rate. The operation time and hospital stay in the observation group were 62.8 ± 9.3 min and 12.5 ± 2.1 days, respectively, while the operation time and length of stay in the control group were 105.6 ± 15.7 min and 18.2 ± 3.4 days, respectively. The operation time and hospitalization time were shorter than those in the control group, and the differences were statistically significant ( P < 0.05). Before surgery, there was no significant difference in serum levels of PRL and GH between the two groups ( P > 0.05). At 1 week after surgery, the levels of PRL and GH in the two groups were significantly lower than those before surgery ( P < 0.05). And the serum levels of PRL and GH in the observation group were significantly lower than those in the observation group at 1 week after the operation ( P < 0.05). Before operation, there was no significant difference between the two groups of KPS and MMSE scores ( P > 0.05). At 1 week after operation, the scores of KPS and MMSE in both groups were significantly higher than those before the operation ( P < 0.05), and the scores of KPS and MMSE in the observation group were significantly higher than those in the control group ( P < 0.05). Furthermore, there was no significant difference in the serum levels of IL-6, IL-12, and TNF-α between the two groups before operation ( P > 0.05). At 1 week after surgery, the serum levels of IL-6, IL-12, and TNF-α in the two groups were significantly lower than those before surgery ( P < 0.05), while the serum levels of IL-6, IL-12, and TNF-α in the observation group were evidently lower than those in the control group at 1 week after the operation. Besides, the incidence of postoperative complications in the observation group was 7.5%, which was significantly lower than that in the control group (17.5%) ( P < 0.05). All the patients in the two groups were followed up for 2 years. And there was no recurrence in the observation group and one case in the control group. The therapeutic effect of EEAs on pituitary adenoma is better. It can improve the level of high endocrine hormone in patients with pituitary adenoma, improve the functional status of the patients, reduce the serum level of inflammatory factors, and shorten the hospital stay. Meanwhile, it also has the characteristics of fewer complications and low recurrence rate, so it can be popularized in clinical practice.