A risk factors analysis on biochemical remission of pituitary tumor patients with acromegaly treated by the endoscopic endonasal surgery / 中国神经精神疾病杂志

ABSTRACT

Objective To study the risk factors of the biochemical remission of pituitary tumor patients with acromegaly treated by the endoscopic endonasal surgery. Methods A retrospective analysis of clinical data was conducted on 61 cases acromegaly patients underwent endoscopic endonasal surgery between August 2013- November 2016.Endocrinology tests were performed in all patients,including the fasting/random GH(growth hormone,GH)level, Nadir GH during OGTT(oral glucose tolerance test, OGTT), and IGF-1(insulin-like growth factor-1,IGF-1). The clinical data included gender, age, preoperative GH value, preoperative IGF-1 value, tumor invasion of the inferface space of internal carotid artery(ICA),tumor surrounding angle of internal carotid artery(≥/<135°),Knosp grade, Hardy grade, and tumor volume. Univariate analysis and multivariate Logistic retrospective analysis were used to analyze the association between above-mentioned factors and the occurrence of biochemical remission. Results There were 52.5% (32/61)patients achieving biochemical remission.Univariate analysis showed significant differences between patients with and without biochemical remission in preoperative GH value, tumor surrounding angle of internal carotid artery(</≥135°)and Knosp grade(P<0.05).The Logistic regression analysis showed that preoperative GH value,tumor surrounding angle of internal carotid artery(</≥135°)were risk factors concerning about the biochemical remission in patients underwent endoscopic endonasal surgery.(P<0.05). Conclusion Tumor surrounding angle of internal carotid artery(≥135°)is independent risk factors, while the preoperative GH value is a risk predictor of biochemical remission after endoscopic endonasal surgery in acromegaly.