Preliminary analysis of the clinical features and surgical efficacy in patients with growth hormone-secreting pituitary adenoma

Abstract

Objective To study the relationship between the clinical features of growth hormone (GH)-secreting pituitary adenomas and surgical treatment. Methods A total of 167 patients with GH adenoma underwent surgical treatment at the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from January 2011 to October 2013 were enrolled. The clinical features of the patients were observed. Its relationship with surgical efficacy was investigated. Immunohistochemical staining was used to observe the hormone expression of adenoma. Results In the 170 patients, the ratio of male and female was 1 ∶1.12 (79/88). The patients of 30 to 50 years accounted for 63.7% (n=106). Twenty-two patients (13.2%) had microadenoma, 117 (70.1%) had macroadenoma, and 28 (16.8%) had giant adenoma. Sixty-three patients (37.7%) had invasive adenoma and 104 (62.3%) had non-invasive adenoma. The resection extent of non-invasive adenomas was higher than that of the invasive ones, and there was significant difference (P=0.01). The median preoperative plasma GH level was 27 ng/ml; there were 43 patients (25.8%) the preoperative prolactin >normal value (20 ng/ml). The preoperative GH level was positively correlated with tumor volume (r=0.285, P<0.01). The preoperative and postoperative GH levels were positively correlated with tumor volume (r=0.541, P<0.01). Immunohistochemistry showed that the plurihormonal positive expression of adenoma accounted for 51.8% (79/164). Single GH hormone positive expression accounted for 48.2% (79/164). There was no significant difference in the invasion and the preoperative GH level between the two groups. The patients were followed up for 0.6 to 4.3 years, 150 of 158 patients with acromegaly were relieved; after procedure, 21.4% of patients with diabetes were cured (9/42) and 21.4% (9/42) were relieved; 16.3% (7/43) of hypertension were cured and 14.0% (6/43) were relieved. Conclusions Ghomas are common in young and middle-aged adults. Most of them are macroadenoma when the diagnosis is clear. The preoperative GH level is associated with the tumor volume. Surgical treatment is effective for part of the patients complicating with hypertension and diabetes. The extent of surgical resection of invasive ghomas is not as ideal as non-invasive ones. Key words: Growth hormone-secreting pituitary adenoma; Disease attributes; Tumor volume; Surgery