Objective: To summarize the correlation between anterior pituitary function and tumor size in patients with different hormone-secreting pituitary adenomas. Methods: This was a retrospective case series study. The clinical data of 1 946 patients with pituitary adenoma hospitalized in the First Medical Center of Chinese PLA General Hospital from January 1, 2005, to December 31, 2020, were collected. The correlation between tumor size and anterior pituitary hormone levels was analyzed using Spearman rank correlation analysis in different types of pituitary adenomas. Results: The median age of the 1 946 patients was 45.1 years, of which 857 (44.0%) were men. The maximum tumor diameter of the patients [M (Q1, Q3)] was 22 (14, 30) mm. Tumor size in nonfunctioning adenomas (n=1 191) was negatively correlated with adrenocorticotropic hormone (ACTH) (r=-0.11, P<0.001), growth hormone (r=-0.13, P<0.001), and luteinizing hormone (men: r=-0.26, P<0.001, women: r=-0.31, all P<0.001). The tumor size of somatotropic adenomas (n=297) was positively correlated with growth hormone (r=0.46, P<0.001), but negatively correlated with male testosterone (r=-0.41, P<0.001). The tumor size of ACTH-secreting pituitary adenomas (n=155) was positively correlated with the ACTH level at 8∶00 AM (r=0.25, P<0.001); however, no correlation was found with cortisol at 8∶00 AM (P>0.05). The tumor size of prolactinomas (n=303) was positively correlated with the prolactin level (men: r=0.34, P=0.001; women: r=0.13, P=0.070). Conclusions: The correlation between the function of the anterior pituitary and size of the tumor depends on the cellular origin of the pituitary adenoma and specific type of hormone secretion. In somatotroph adenomas, ACTH-secreting pituitary adenomas, and prolactinomas, there is a positive correlation between tumor size and level of hormones secreted by the corresponding tumors. In patients with nonfunctioning adenomas, the tumor size was negatively correlated with the hormone levels of the pituitary-adrenal and pituitary-growth hormone axes.
目的： 总结不同激素分泌类型垂体腺瘤患者垂体前叶功能与肿瘤大小的相关性。 方法： 回顾性病例系列研究。收集2005年1月1日至2020年12月31日就诊于解放军总医院第一医学中心的1 946例垂体腺瘤患者的临床资料。采用Spearman秩相关分析不同类型的垂体腺瘤的肿瘤大小与垂体前叶激素水平的相关性。 结果： 1 946例垂体腺瘤患者中男性857例（44.0%），中位确诊年龄45.1岁，肿瘤最大直径［M（Q1，Q3）］为22（14，30）mm。1 191例无功能瘤的肿瘤大小与促肾上腺皮质激素（ACTH）（r=-0.11，P<0.001）、生长激素（r=-0.13，P<0.001）及黄体生成素水平负相关（男性：r=-0.26，P<0.001，女性：r=-0.31，P<0.001）；297例生长激素瘤的肿瘤大小与生长激素正相关（r=0.46，P<0.001），而与男性睾酮水平负相关（r=-0.41，P<0.001）；155例ACTH瘤的肿瘤大小与8∶00 AM的ACTH水平正相关（r=0.25，P<0.001），而与8∶00 AM皮质醇之间未发现相关性（P>0.05）；303例泌乳素瘤的肿瘤大小与泌乳素水平呈正相关趋势（男性：r=0.34，P=0.001；女性：r=0.13，P=0.070）。 结论： 垂体前叶功能与肿瘤大小的相关性与垂体瘤的细胞来源及特定的激素分泌类型有关。生长激素瘤、ACTH瘤及泌乳素瘤中，均表现出肿瘤大小与其肿瘤对应高分泌激素水平的正相关关系，而无功能瘤患者的肿瘤大小与垂体-肾上腺轴、垂体-生长激素轴的激素水平负相关。.