上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

初发恶性与复发恶性嗜铬细胞瘤临床特征的比较分析

曹万里，黄宝星，孙福康，周文龙，黄欣，戴军，祝宇，吴瑜璇，张荣明，沈周俊   

  1. 上海交通大学 医学院附属瑞金医院泌尿外科， 上海 200025
  • 出版日期:2015-08-28 发布日期:2015-09-30
  • 通讯作者: 孙福康, 电子信箱: sunfukang6@126.com。
  • 作者简介:曹万里（1987—）， 男， 硕士生; 电子信箱: wanli.cao@hotmail.com。
  • 基金资助:

    上海市教委科研创新项目(14YZ050)

Comparison and analysis of clinical features of primary and recurrent malignant pheochromocytoma

CAO Wan-li, HUANG Bao-xing， SUN Fu-kang, ZHOU Wen-long, HUANG Xin, DAI Jun, ZHU Yu, WU Yu-xuan, ZHANG Rong-ming, SHEN Zhou-jun   

  1. Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2015-08-28 Published:2015-09-30
  • Supported by:

    Shanghai Municipal Education Commission Foundation, 14YZ050

PDF (PC)

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摘要：

目的  探讨初发恶性嗜铬细胞瘤与复发恶性嗜铬细胞瘤患者术中情况及预后的不同特征。方法  回顾性分析嗜铬细胞瘤患者284例，将病理诊断为生物学恶性潜能及发生远处转移的32例嗜铬细胞瘤患者纳入研究。将32例患者分为两组：初发恶性嗜铬细胞瘤组17例，复发恶性嗜铬细胞瘤组15例。对两组患者基线资料、术中情况及预后特征进行比较和分析。结果  病理诊断为生物学恶性的患者，与有远处转移的患者比较，基线资料一致，但预后显著优于后者(P=0.015)。复发恶性嗜铬细胞瘤患者行毗邻器官切除术及减瘤手术的风险显著高于初发恶性嗜铬细胞瘤患者(P=0.023, P=0.016)。术后随访结果显示：复发恶性嗜铬细胞瘤患者的预后均显著差于初发恶性嗜铬细胞瘤患者(P=0.029, P=0.025)，并与肿瘤具有生物学恶性潜能或已发生转移性病变无显著关联。结论  手术仍是恶性嗜铬细胞瘤的主要治疗方式；与初发恶性嗜铬细胞瘤患者相比，复发恶性患者手术风险增加，预后更差。

关键词: 嗜铬细胞瘤, 恶性, 诊断, 治疗, 预后

Abstract:

Objective  To explore the differences of intraoperative conditions and prognosis between patients with primary malignant pheochromocytomas (pheos) and recurrent malignant pheos. Methods  A total of 284 cases of pheos were retrospectively analyzed and 32 cases that were pathologically diagnosed with biological malignance or metastasis were included in the study and divided into the primary malignant pheos group (n=17) and recurrent malignant pheos group (n=15). Baseline characteristics, intraoperative conditions, and prognosis of two groups were compared and analyzed. Results  Compared with patients pathologically diagnosed with metastasis, baseline characteristics of patients pathologically diagnosed with biological malignance were similar, while the prognosis was much better (P=0.015). The risk of surrounding organs excision and debulking surgery of patients with recurrent malignant pheos was significantly higher than that of patients with primary malignant pheos (P=0.023, P=0.016). Results of postoperative follow-ups showed that the prognosis of patients with recurrent malignant pheos was significantly worse than that of patients with primary malignant pheos (P=0.029, P=0.025) and the prognosis was not significantly correlated with biological malignance or metastasis. Conclusion  Surgical removal is still the main treatment for malignant pheos. Compared with patients with primary malignant pheos, the operation risk of patients with recurrent malignant pheos increases and the prognosis is worse.

Key words: pheochromocytoma, malignance, diagnosis, treatment, prognosis