大多数垂体腺瘤，也称为垂体神经内分泌肿瘤（PitNET），本质上是良性的，可以通过手术切除、药物治疗以及特殊情况下的放射治疗来有效治疗。然而，侵袭性生长可能是更具攻击性行为和不良预后的一个重要特征。垂体腺瘤延伸至海绵窦可根据核磁共振成像 (MRI) 的诺斯普标准进行分类。不同临床因素对 MRI 特征和术中侵袭性生长结果的比较分析仍然很少。我们对 2004 年 10 月至 2018 年 4 月期间接受手术治疗的 764 例垂体腺瘤进行回顾性单中心分析。报告和术前 MR 成像（Knosp 标准）。收集患者诊断时年龄和性别、组织病理学腺瘤类型以及切除范围等临床数据。24.4%（Knosp 3A - 4 级，186/764）的病例在 MRI 上可见侵袭性特征。术中出现浸润的比例为 42.4% (324/764)。 80.0% 的腺瘤实现完全切除，20.1% 的腺瘤次全切除。通过多变量分析，术中发现的侵袭与稀疏颗粒促肾上腺皮质激素细胞（SGCA，p = 0.0026）和稀疏颗粒生长激素细胞（SGSA，p = 0.0103）腺瘤类型以及年龄相关（p = 0.0287）。根据 Knosp 3A-4 级的放射学浸润与年龄 (p=0.0098)、SGCA (p=0.0005)、SGSA (p=0.0351) 和促性腺激素腺瘤 (p=0.0478) 相关。这两种浸润标准均与次全切除相关 (p = 0.0001，分别）。术中和影像学中的浸润性生长迹象都是切除不完全的高危病变，并且在老年患者中更常见。在稀疏颗粒状促肾上腺皮质激素细胞和生长激素细胞腺瘤类型中，侵袭发生率特别高。海绵窦侵犯在促性腺激素腺瘤中也更常见。 Knosp 分类的使用是一种有价值的术前评估工具。© 作者 2024。由牛津大学出版社代表欧洲内分泌学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限均可通过我们网站文章页面上的“权限”链接通过我们的 RightsLink 服务获得 - 欲了解更多信息，请联系journals.permissions@oup.com。

Most pituitary adenomas, also termed pituitary neuroendocrine tumors (PitNETs), are benign in nature and can be treated effectively by surgical resection, medical treatment and in special cases by radiotherapy. However, invasive growth can be an important feature of a more aggressive behavior and adverse prognosis. Extension of pituitary adenomas into the cavernous sinus can be categorized according to the Knosp criteria on magnetic resonance imaging (MRI). Comparative analyses of MRI features and intraoperative findings of invasive growth regarding different clinical factors are still scarce.We performed a retrospective single-center analysis of 764 pituitary adenomas that were surgically treated between October 2004 and April 2018. Invasive growth was assessed according to the surgical reports and preoperative MR imaging (Knosp criteria). Clinical data such as patient age at diagnosis and gender, histopathological adenoma type as well as extent of resection were collected.Invasive features on MRI were seen in 24.4% (Knosp grade 3A - 4, 186/764) of cases. Intraoperatively, invasion was present in 42.4% (324/764). Complete resection was achieved in 80.0% of adenomas and subtotal resection in 20.1%. By multivariate analysis, invasion according to intraoperative findings was associated with the sparsely granulated corticotroph (SGCA, p=0.0026) and sparsely granulated somatotroph (SGSA, p=0.0103) adenoma type as well as age (p=0.0287). Radiographic invasion according to Knosp grades 3A-4 correlated with age (p=0.0098), SGCAs (p=0.0005), SGSAs (p=0.0351) and gonadotroph adenomas (p=0.0478).Both criteria of invasion correlated with subtotal resection (p=0.0001, respectively).Both intraoperative and radiographic signs of invasive growth are high-risk lesions for incomplete extent of resection and occur more frequently in older patients. A particularly high prevalence of invasion can be found in the sparsely granulated corticotroph and somatotroph adenoma types. Cavernous sinus invasion is also more common in gonadotroph adenomas. Usage of the Knosp classification is a valuable preoperative estimation tool.© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.