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Endoscopic Transsphenoidal Surgery for pituitary adenoma. Early Experience in Sohag University Hospitals

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Open Journal of Modern Neurosurgery 2021年第3期11卷 194-203页

作者： Karam Kenawy Ahmed Ismail Ibrahim Rezk Abdin K. Kasim Department of Neurosurgery Sohag University Sohag Egypt Department of E.N.T Sohag University Sohag Egypt

Objective: To report the results of our first series of patients undergoing a purely endoscopic endonasal approach for pituitary surgery in Sohag University Hospitals. Patients and Methods: We reviewed 20 consecutive patients during the period from January 2017 to January 2020 with pituitary adenoma who underwent purely endoscopic transsphenoidal resection of their lesions. The patients’ clinical outcomes, degrees of tumor removal, and complications were reported. Results: There were 18 primary and 2 recurrent adenomas (19 nonfunctioning and 1 functioning GH secreting adenoma). The average degree of gross total removal for tumors was 70%, C.S.F leak occurred in 20%, diabetes insipidus in 10% and sellar hemorrhage in 5%. There was no post-operative mortality, vascular injury, sphenoiditis, septal perforation, epistaxis or general complication. Conclusion: A purely endoscopic approach for pituitary adenoma treatment is a safe and effective alternative to the traditional microscopic procedure.

关键词： Endoscopic Surgery Endonasal pituitary adenoma Transsphenoidal Outcome Complications

Gangliocytoma combined with a pituitary adenoma:Reports of three cases and literature review

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Translational Neuroscience and Clinics 2016年第3期2卷 165-171页

作者： Zhenmin Wang Peng Li Qiangyi Zhou Zhijun Yang Pinan Liu Department of Neurosurgery Beijing Tiantan Hospital Capital Medical University Department of Neural Reconstruction Beijing Neurosurgery Institute Capital Medical University

Objectives: Sellar gangliocytomas are extremely rare. Since they present clinically and radiologically as pituitary adenomas, the preoperative diagnosis of these mixed tumors is very difficult. Here, we report three cases of gangliocytoma combined with pituitary adenoma and describe our findings. Methods: The clinical data of the three cases of gangliocytoma combined with pituitary adenoma have been retrospectively analyzed, and the published literature has also been reviewed. Results: All three patients underwent pure endonasal endoscopic surgery, and no recurrence was observed over a follow-up of at least 30 months. Growth hormone(GH)-hypersecreting adenoma and tumor calcification were detected in these mixed tumors. Conclusions: Pure endoscopic transnasal transsphenoidal surgery may be an effective way for the treatment of this kind of tumor. Gross total resection of the tumor is recommended. In addition, calcification with GH-hypersecretion may serve as a preoperative diagnostic clue for gangliocytoma in the sella turcica.

关键词： gangliocytoma pituitary adenoma calcification diagnosis

Effect of Single Nostril Transsphenoidal Resection of pituitary adenoma under Neuroendoscope on Hospitalization Time and Bleeding Volume in Patients with pituitary adenoma

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Journal of Clinical and Nursing Research 2022年第1期6卷 41-45页

作者： Haipeng Yuan Changle Hospital of Traditional Chinese Medicine Weifang 262400Shandong ProvinceChina

Objective:This study mainly discusses the clinical effect of treating pituitary adenoma by using single nostril transsphenoidal resection of pituitary adenoma under neuro-endoscope,and analyzes the influence on hospitalization time and bleeding ***:A total of 335 patients with pituitary adenoma treated in our hospital from January 2017 to January 2019 were randomly selected for *** patients were divided into two groups by number table method.167 patients in the reference group underwent single nostril transsphenoidal resection of pituitary adenoma under ***,168 patients in the study group underwent single nostril transsphenoidal resection of pituitary adenoma under *** hospitalization time and bleeding volume and other surgical treatment effects were observed and ***:There was no significant difference in the levels of prolactin(PRL),adrenocorticotropic hormone(ACTH)and thyroid stimulating hormone(TSH)between the two groups before operation(P>0.05);After surgical treatment,the levels of PRL,ACTH and TSH in the study group were lower than those in the control group(Ppituitary adenoma diseases,using single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope can improve the tumor resection rate,reduce the bleeding volume and shorten postoperative hospitalization time.

关键词： Neuroendoscope Single nostril transsphenoidal resection of pituitary adenoma pituitary adenoma

Relationship Between Histopathology and Clinical Prognosis of Invasive pituitary adenoma

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The Chinese-German Journal of Clinical Oncology 2005年第3期4卷 179-182,190-191页

作者：李勇舒凯董芳永万锋雷霆李龄武汉华中科技大学同济医学院附属同济医院神经外科 430030

Objective: To study the relationship between histopathology and clinical prognosis of invasive pituitary adenoma subjected to transsphenoidal surgery. Methods: The enrolled were 82 patients with invasive pituitary adenomas undergoing transsphenoidal surgery during Jan. 2000 - May 2003 in our department with full MR imaging findings, pathology data and follow-up information. The follow-up duration was 5-30 months. Results: MR imaging findings of invasive pituitary adenoma included: depression of the sellar floor, involvement of sphenoid sinus and cavernous sinus, breakthrough of diaphragma sellae, encasement of internal carotid artery, etc. Pathological examination revealed that the invasion rate of dura in sella turcica was the highest among the structures around tumor. pituitary adenoma apoplexy was found in 20 cases (24.4%). The total removal rate for PRL-secreting adenomas was significantly lower than that for non-secreting adenomas (Padenomas had no significant differences. The recurrence rate of PRL-secreting adenomas was higher than that of non- and GH-secreting adenomas (Ppituitary adenomas, the therapeutic effects of non-and GH-secreting pituitary adenomas are better than that of PRL-secreting adenomas. Invasive biological behaviors of invasive pituitary adenomas result in radical operation failure and postoperative recurrence.

关键词： pituitary adenoma invasion transsphenoidal surgery MRI histopathology

Role of galanin and its receptors in pituitary adenoma invasion

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Role of galanin and its receptors in pituitary adenoma invas...

Transsphenoidal surgery for pituitary adenoma in elderly patients

中国神经科学学会第十届全国学术会议

作者： Zhu MEI Ke-Qian MA Yu-Tao YANG Wang JIA Zhi-Qing David XU Beijing Center of Neural Regeneration & Repair Department of NeurobiologyBeijing Key Laboratory of Brain Major DisordersCapital Medical University Beijing Institute for Neurosurgery Tiantan Hospital

Objective Invasive pituitary adenoma is one of the neurosurgical problems as it can not be completely removed by surgery and has high relapse rate and poor quality of *** previous studies have shown that me mRNA expression level of galanin,a neuropeptide,was higher in non-invasive pituitary adenoma tissues than invasive pituitary adenoma tissues and all three galanin receptor subtypes were detected in the rat GH3 tumor cells with particularly high expression levels of *** objective of this study is to investigate the role of galanin and its receptors on invasion in rat pituitary adenoma GH3 tumor cells,define receptor subtype involved,and explore the potential signal *** Matrigel-coated Transwell Invasion Assay was performed to determine the role of galanin and its receptors in suppression of GH3 tumor cells invasion *** Solution Assay was applied to measure the cell vitality in each group at different time points after drug *** Blotting was used to study effect of galanin and GalR2agonist AR-M1896 on the phosphorylation of ERK in rat GH3 tumor ***（1） The invasion capacity of tumor cells was decreased significantly in rat pituitary GH3 tumor cells with galanin and AR-M1896 treatment compared with control group.（2） There was no significant difference in cell proliferation levels between the presence and absence of galanin or AR-M1896.（3） The suppression effect of galanin on tumor cell invasion was reduced after knocking down GalR2 with siRNA.（4） Application of galanin and AR-M1896 markedly stimulated phosphorylation of ERK in GH3tumor *** Galanin inhibits rat pituitary adenoma tumor cells invasion,mainly mediated by GalR2.

关键词： galanin GH3 cells pituitary adenoma transwell invasion assay

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Transsphenoidal surgery for pituitary adenoma in elderly pat...

pituitary prolactin adenoma with Toxoplasma gondii infection

2009年浙江省神经外科学术年会

作者： Department of Neurosurgery The First Hospital of Hangzhou Hangzhou(310006) China Hui Guozhen Department of Neurosurgery The First Affliated Hospital of Suzhou University Yu Wenhua Xu Peiyuan Zhu Qiang Che Zhihao

Purpose To evaluate the presentation and perioperative risk associated with transsphenoidal surgery in patients over the age of ***.A retrospective chart review was undertaken for patients over the age of 65 undergoing transsphenoidal surgery between 2003 and ***-four patients over the age of 65 were identified with an average age of 70.4 years(range 65-84).The average follow-up period was 44 months(range 14- 104).Symptoms of mass effect were the presenting complaint in 72%of patients while 9%had documentation of growth on imaging *** percent presented with a history consistent with *** patients (5%) presented with ***-operative hospital stay averaged 2.6 days(range 2-7).Eight patients had new hormonal deficits post-operatively(1ACTH,3 TSH,2 ACTH/TSH,2 vasopressin).There were no cardiopulmonary complications and no deaths within 90 days of *** surgery can be performed in patients over the age of 65 without undo significant *** removal of pituitary adenomas should be considered the mainstay of treatment in elderly patients in whom treatment is *** who are medically suitable candidates should be offered surgical resection as would their younger counterparts.

关键词： Elderly pituitary adenoma transsphenoidal surgery

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Journal of Medical Colleges of PLA(China) 2003年第1期18卷 48-50页

作者：张晓晖李青程虹阎庆国黄高昇 Department of Pathology Xijing HospitalFourth Military Medical University

Objective: To report two recent cases of pituitary adenoma associated with Toxoplasma gondii (***) ***: Histological changes were observed in H & E and PAS staining sections *** was performed to classify the pituitary tumors and to confirm the diagnosis of ***: The cases were 43- and 19-year-old females, in which the latter one was a recurring case, and radiology examination showed that tumors existed in sellar ***, the tumors consisted of small homogenous polygonal or round cells with abundant eosinophilic granular *** revealed they were prolactin-producing ***, we found toxoplasma infection in the tumor tissues, being confirmed by *** sepicific antibody ***: The association of pituitary adenoma with toxoplasma raises the possibility that *** may be involved in the development of certain cases of pituitary adenoma.

关键词： pituitary adenoma Toxoplasma gondii etiology

Celastrol Induces Apoptosis and Autophagy via the AKT/mTOR Signaling Pathway in the pituitary ACTH-secreting adenoma Cells

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Current Medical Science 2022年第2期42卷 387-396页

作者： Zhi CAI Bin QIAN Jing PANG Zhou-bin TAN Kai ZHAO Ting LEI Sino-German Neuro-Oncology Molecular Laboratory Department of NeurosurgeryTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Key Laboratory of Human Functional Genomics of Jiangsu Province Biochemistry and Molecular BiologyNanjing Medical UniversityNanjing211100China Department of Biochemistry and Molecular Cell Biology Shanghai Jiao Tong University School of MedicineShanghai200240China

Objective pituitary adrenocorticotropic hormone(ACTH)-secreting adenoma is a relatively intractable endocrine adenoma that can cause a range of severe metabolic disorders and pathological changes involving multiple *** studies have shown that celastrol has antitumor effects on a variety of tumor cells via the AKT/mTOR ***,whether celastrol has pronounced antitumor effects on pituitary ACTH-secreting adenoma is *** study aimed to identify a new effective therapeutic drug for pituitary ACTH-secreting *** Mouse pituitary ACTH-secreting adenoma cells(AtT20 cells)were used as an experimental model in vitro and to establish a xenograft tumor model in *** and animals were administered doses of celastrol at various *** effects of celastrol on cell viability,migration,apoptosis and autophagy were then ***,the potential involvement of AKT/mTOR signaling in celastrol’s mechanism was *** Celastrol inhibited the proliferation and migration of pituitary adenoma cells in a time-and concentration-dependent *** blocked AtT20 cells in the G0/G1 phase,and induced apoptosis and autophagy by downregulating the AKT/mTOR signaling *** results were obtained in *** Celastrol exerts potent antitumor effects on ACTH-secreting adenoma by downregulating the AKT/mTOR signaling in vitro and in vivo.

关键词： pituitary adenoma celastrol autophagy apoptosis AKT/mTOR signaling pathway

Study on the Expression Levels of CXCR4, CXCL12, CD44, and CD147 and Their Potential Correlation with Invasive Behaviors of pituitary adenomas

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Biomedical and Environmental Sciences 2013年第7期26卷 592-598页

作者： XING Bing KONG Yan Guo YAO Yong LIAN Wei WANG Ren Zhi REN Zu Yuan Departments of Neurosurgery Key Laboratory of Endocrinology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

Objective To evaluate the factors of CXCR4, CXCL12, CD44, and CD147 as early potential diagnostic biomarkers by determining their expression levels in invasive and non-invasive pituitary adenomas. Methods Fresh pituitary adenoma specimens were collected from 35 pituitary adenoma （21 invasive and 14 non-invasive） patients who underwent surgical treatment in our Neurosurgery Department between January and April of 2009. The expression levels of CXCR4, CXCL12, CD44, and CD147 were evaluated firstly by flow cytometry, fluorescence microscopy in single cell suspensions, and then by immunohistochemical staining of paraffin tissue sections. Results Flow cytometric analyses showed that the percentage of CXCR4- and CXCL12-positive cells from invasive pituitary adenomas （IPA） was significantly higher in the single cell suspensions than that from non-invasive pituitary adenomas （nlPA）（P〈O.05）. Immunohistochemical staining revealed that CXCR4 and CXCL12 staining index scores of the invasive pituitary adenomas were significantly higher than those of the non-invasive pituitary adenomas （P〈O.05）. In contrast, neither flow cytometry nor immunohistochemical staining demonstrated significant difference between CD44 and CD147 expression levels, respectively. Conclusion Expression levels of CXCR4 and CXCL12 are correlated with the invasiveness of pituitary adenomas. Therefore, rather than CD44 and CD147, CXCR4 and CXCL12 may potentially serve as biomarkers for early detection of pituitary adenomas.

关键词： pituitary adenoma Invasiveness Flow cytometry Immunohistochemistry CXCR4, CXCL12,CD44, and CD147