
浏览全部资源
扫码关注微信
重庆医科大学附属第一医院泌尿外科,重庆 400016
刘佳渝,Email:urologistliu2022@163.com, 研究方向:泌尿系结石与肿瘤的临床诊治。
张高杰,Email:urologistzhang2022@163.com。
收稿:2023-05-26,
修回:2023-06-22,
录用:2023-07-08,
纸质出版:2023-08-28
移动端阅览
刘佳渝,彭钺强,王林峰,等.不同年龄段嗜铬细胞瘤患者临床病理特点及围术期临床特征分析[J].重庆医科大学学报,2023,48(8):971-977.
Liu Jiayu,Peng Yueqiang,Wang Linfeng,et al.Clinicopathological and perioperative clinical characteristics of patients with pheochromocytoma of different ages[J].Journal of Chongqing Medical University,2023,48(8):971-977.
刘佳渝,彭钺强,王林峰,等.不同年龄段嗜铬细胞瘤患者临床病理特点及围术期临床特征分析[J].重庆医科大学学报,2023,48(8):971-977. DOI: 10.13406/j.cnki.cyxb.003294.
Liu Jiayu,Peng Yueqiang,Wang Linfeng,et al.Clinicopathological and perioperative clinical characteristics of patients with pheochromocytoma of different ages[J].Journal of Chongqing Medical University,2023,48(8):971-977. DOI: 10.13406/j.cnki.cyxb.003294.
目的
2
探寻不同年龄段之间嗜铬细胞瘤患者的临床病理特点及围术期临床特征,为临床嗜铬细胞瘤患者个体化治疗提供更多的理论基础。
方法
2
回顾性收集2012年至2022年入住重庆医科大学附属第一医院经病理证实且接受手术治疗的213例嗜铬细胞瘤患者的临床病理特征及围术期资料,根据年龄差异分成青年、中年、老年3组。并对3组嗜铬细胞瘤患者的临床病理指标及围术期特征进行比较分析。
结果
2
病灶大小、术中出血量、体质指数、术前合并症、入院症状、术中血压波动及病理特征的分布在3组间差异均有统计学意义(
P
<
0.05)。其中,老年患者病灶直径最大,术后活检病理特征为NSE阳性的比例最高,且术后更易出现营养相关
性并发症;青年组增殖细胞核抗原(proliferation cell nuclear antigen,Ki-67)阳性率最高,在入院时伴发嗜铬细胞瘤相关症状的比例最高,且易发生高血压危象和术中出血;中年组更易出现术中血压波动,但总住院时间相对较短。
结论
2
不同年龄段嗜铬细胞瘤患者在术后并发症、入院症状、术中血压波动等方面具有差异性,因此应针对不同年龄段患者进行个体化治疗。
Objective
2
To explore the clinicopathological characteristics and perioperative clinical characteristics of patients with pheochromocytoma of different ages,and to provide more theoretical bases for individualized treatment of patients with pheochromocytoma in clinical practice.
Methods
2
The clinicopathological and perioperative data of 213 patients with pheochromocytoma who were pathologically confirmed and surgically treated in our hospital from 2012 to 2022 were retrospectively analyzed,and the patients were divided into three groups according to age: youth,middle-aged,and elderly groups. The clinicopathological indices and perioperative characteristics of patients with pheochromocytoma in the three groups were compared and analyzed.
Results
2
There were significant differences in lesion size,intraoperative blood loss,body mass index,preoperative complications,admission symptoms,intraoperative blood pressure fluctuation,and pathological characteristics among the three groups(
P
<
0.05). The elderly group had the largest lesion diameter,the highest proportion of positive NSE in postoperative biopsy pathology,and the highest incidence of postoperative nutrition-related complications. The youth group had the highest positive rate of Ki-67,the highest proportion of pheochromocytoma-related symptoms on admission,and the highest incidence of hypertension crisis and intraoperative bleeding. The middle-aged group had the highest incidence of intraoperative blood pressure fluctuation,but shorter total length of hospital stay.
Conclusion
2
Pheochromocytoma patients of different age groups have variability in postoperative complications,admission symptoms,and intraoperative blood pressure fluctuations,so treatment should be individualized for patients of different ages.
Al Subhi A , Boyle , Elston MS . Systematic review: incidence of pheochromocytoma and paraganglioma over 70 years [J ] . J Endocr Soc , 2022 , 6 ( 9 ): bvac105 .
Urabe F , Kimura S , Iwatani K , et al . Risk factors for perioperative hemodynamic instability in pheochromocytoma:a systematic review and Meta-analysis [J ] . J Clin Med , 2021 , 10 ( 19 ): 4531 .
黄风怡 , 龚灿生 , 郑 艇 , 等 . 嗜铬细胞瘤或副神经节瘤患者术后发生严重并发症的影响因素 [J ] . 中外医学研究 , 2022 , 20 ( 18 ): 5 - 11 .
Huang FY , Gong CS , Zheng T , et al . Influence factors for severe postoperative complications in pheochromocytoma or paraganglioma patients [J ] . Chin Foreign Med Res , 2022 , 20 ( 18 ): 5 - 11 .
Wang X , Zhao Y , Liao ZC , et al . Surgical strategies of complicated pheochromocytomas/paragangliomas and literature review [J ] . Front Endocrinol , 2023 , 14 : 1129622 .
Xia ZY , Li JZ , Peng L , et al . Comparison of perioperative outcomes of robotic-assisted vs laparoscopic adrenalectomy for pheochromocytom a:a Meta-analysis [J ] . Front Oncol , 2021 , 11 : 724287 .
Bihain F , Klein M , Nomine-Criqui C , et al . Robotic adrenalectomy in patients with pheochromocytoma:a systematic review [J ] . Gland Surg , 2020 , 9 ( 3 ): 844 - 848 .
Yao Y , Guo Y , Fan J , et al . Influence of duration of preoperative treatment with phenoxybenzamine and secretory phenotypes on perioperative hemodynamics and postoperative outcomes in pheochromocytoma and paraganglioma [J ] . Front Endocrinol , 2023 , 14 : 1139015 .
Zhao L , Zhang T , Meng X , et al . Factors contributing to development and resolution of dysglycemia in patients with pheochromocytomas and catecholamine-secreting paragangliomas [J ] . Ann Med , 2023 , 55 ( 1 ): 2203945 .
Fang F , Ding L , He Q , et al . Preoperative management of pheochromocytoma and paraganglioma [J ] . Front Endocrinol , 2020 , 11 : 586795 .
樊 华 , 李汉忠 , 纪志刚 , 等 . 嗜铬细胞瘤/副神经节瘤术中血压骤升的临床特征分析(附单中心219例报告) [J ] . 中华泌尿外科杂志 , 2019 , 40 ( 4 ): 267 - 271 .
Fan H , Li HZ , Ji ZG , et al . Analysis of clinical characteristics for hypertensive attack during pheochromocytoma and paraganglioma operation:a single center case report of 219 cases [J ] . Chin J Urol , 2019 , 40 ( 4 ): 267 - 271 .
Pasieka JL . Re-evaluating ‘surgical dogma’ in the postoperative management of pheochromocytoma/paragangliomas:reflecting on the data cannot help but to bring about change [J ] . World J Surg , 2021 , 45 ( 3 ): 797 - 798 .
Nölting S , Bechmann N , Taieb D , et al . Personalized management of pheochromocytoma and paraganglioma [J ] . Endocr Rev , 2022 , 43 ( 2 ): 199 - 239 .
Khan M , Hashmi Z , Ghafoor A . Rare case of pheochromocytoma in a young female [J ] . J Coll Physicians Surg Pak , 2019 , 29 ( 4 ): 398 - 399 .
Eisenhofer G , Lenders JWM . Biochemical diagnosis of pheochromocytoma,a rediscovered catecholamine-metabolizing tumor [J ] . Clin Chem , 2018 , 64 ( 12 ): 1780 - 1781 .
Ma XP , Chen Z , Xia P , et al . Giant paraganglioma complicated with catecholamine crisis and catecholamine cardiomyopathy:a case report and review of the literature [J ] . Front Endocrinol , 2021 , 12 : 790080 .
Aw A , de Jong MC , Varghese S , et al . A systematic cohort review of pheochromocytoma-induced typical versus atypical Takotsubo cardiomyopathy [J ] . Int J Cardiol , 2023 , 371 : 287 - 292 .
Dogra P , Sundin A , Juhlin CC , et al . Rare benign adrenal lesions [J ] . Eur J Endocrinol , 2023 , 188 ( 4 ): 407 - 420 .
Calissendorff J , Juhlin CC , Sundin A , et al . Adrenal cysts:an emerging condition [J ] . Nat Rev Endocrinol , 2023 , 19 ( 7 ): 398 - 406 .
徐逸昕 , 王一波 , 丁 蔚 , 等 . 不同年龄段老年直肠癌的临床特征及术后并发症的危险因素分析 [J ] . 安徽医学 , 2017 , 38 ( 11 ): 1448 - 1451 .
Xu YX , Wang YB , Ding W , et al . Analysis of clinicopathological features and risk factors for postoperative complications at different ages in elderly patients with rectal cancer [J ] . Anhui Med J , 2017 , 38 ( 11 ): 1448 - 1451 .
Nottebaum BJ , Groeben H . Anästhesiologisches management Bei phäochromozytomoperationen [J ] . Urologe , 2016 , 55 ( 6 ): 723 - 731 .
Xu B , Chen Z , Tang GR . The current role of clevidipine in the management of hypertension [J ] . Am J Cardiovasc Drugs , 2022 , 22 ( 2 ): 127 - 139 .
Brue T , Amodru V , Castinetti F . Management of endocrine disease:management of Cushing’s syndrome during pregnancy:solved and unsolved questions [J ] . Eur J Endocrinol , 2018 , 178 ( 6 ): R259 - R266 .
李佳颖 , 杨婷瑄 , 季润青 , 等 . 中西部地区老年未控制高血压患者家庭血压监测情况及其影响因素 [J ] . 中华心血管病杂志 , 2022 , 50 ( 10 ): 1007 - 1013 .
Li JY , Yang TX , Ji RQ , et al . Status of home blood pressure monitoring and influencing factors of regular home blood pressure monitoring among elderly uncontrolled hypertensive patients in Central and Western China [J ] . Chin J Cardiol , 2022 , 50 ( 10 ): 1007 - 1013 .
Allon VU , van de Wiel Elle CJ , Jordache R , et al . Predicting surgical outcome in posterior retroperitoneoscopic adrenalectomy with the aid of a preoperative nomogram [J ] . Surg Endosc , 2022 , 36 ( 9 ): 1 - 9 .
Tevosian SG , Ghayee HK . Pheochromocytoma/paraganglioma:a poster child for cancer metabolism [J ] . J Clin Endocrinol Metab , 2018 , 103 ( 5 ): 1779 - 1789 .
赵 琳 , 周 怡 , 刘欣畅 , 等 . 嗜铬细胞瘤和副神经节瘤的分子遗传学特点 [J ] . 国际遗传学杂志 , 2022 , 45 ( 5 ): 368 - 375 .
Zhao L , Zhou Y , Liu XC , et al . Molecular genetic characteristics of pheochromocytoma and paraganglioma [J ] . Int J Genet , 2022 , 45 ( 5 ): 368 - 375 .
Menon SS , Guruvayoorappan C , Sakthivel KM , et al . Ki-67 protein as a tumour proliferation marker [J ] . Clin Chimica Acta , 2019 , 491 : 39 - 45 .
Guadagno E , D’Avella E , Cappabianca P , et al . Ki-67 in endocrine neoplasms:to count or not to count,this is the question!A systematic review from the English language literature [J ] . J Endocrinol Invest , 2020 , 43 ( 10 ): 1429 - 1445 .
Srougi V , Chambo JL , Tanno FY , et al . Presentation and surgery outcomes in elderly with pheocromocytoma:a comparative analysis with young patients [J ] . Int Braz J Urol , 2016 , 42 ( 4 ): 671 - 677 .
Georgakopoulou VE , Zygouris E , Damaskos C , et al . Prognostic value of the immunohistochemistry markers CD56,TTF-1,synaptophysin,CEA,EMA and NSE in surgically resected lung carcinoid tumors [J ] . Mol Clin Oncol , 2022 , 16 ( 2 ): 31 - 37 .
0
浏览量
6
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621