肿瘤床出血的非典型垂体腺瘤组织中Ki-67与CD34的表达*
Expressions of Ki-67 and CD34 in tissue from atypical pituitary adenoma with tumor bed bleeding

目的:探讨CD34在发生肿瘤床出血(TBB)的非典型垂体腺瘤(APA)组织中的表达及与TBB的关系。方法:收集194例手术治疗的垂体腺瘤患者资料,采用免疫组化法检测Ki-67和CD34的表达情况,研究17例APA的临床资料、MRI表现和免疫组化特点,分析APA术中发生TBB与CD34表达水平之间的关系。结果:17例APA均为巨大腺瘤; 14例APA术中发生少到中等量的出血,肿瘤全部切除; 2例出现严重的TBB,行肿瘤次全切术。MRI表现多为T1WI等信号或T2WI等-高信号,增强扫描明显强化。17例APA的Ki-67 LI范围为3.2%～12.0%; CD34在发生TBB的16例APA与无TBB垂体腺瘤组织中的表达量分别为(26.8±7.7)和(10.6±5.3),差异有统计学意义(P=0.025)。结论:CD34阳性表达和肿瘤富血供的MRI表现特点相结合有助于了解APA发生TBB的机制,判断和预测APA的预后。
Aim: To investigate the expression of CD34 in atypical pituitary adenoma(APA)tissue with tumor bed blooding(TBB)and its relationship with TBB.Methods: A total of 194 cases of pituitary adenomas accepting surgery were collected and the expressions of Ki-67 and CD34 were detected by immunohistochemical method. The clinical data, MRI manifestation and immunohistochemical features of 17 cases of APA were studied. The relationship between TBB during the operation and CD34 expression was analyzed.Results: The 17 APA were all macro-adenoma. Among them,14 APA with gross-total resection underwent few to moderate TBB during the operation and 2 APA with subtotal resection experienced severe TBB. Most MRI manifestations of APA were iso-intensity on T1WI and iso-hyperintensity on T2WI with obvious enhancement.Ki-67 LI of 17 cases of APA were 3.2%～12.0%. The positive expression values of CD34 were(26.8±7.7)and(10.6±5.3)in 16 cases of APA with TBB and pituitary adenomas without TBB(P=0.025).Conclusion: The combination of CD34 positive expression and hypervascular MRI manifestation helps to understand the mechanism of TBB, judge and predict the prognosis of APA