Asban Ammar, Kluijfhout Wouter P, Drake Frederick T, Beninato Toni, Wang Elizabeth, Chomsky-Higgins Kate, Shen Wen T, Gosnell Jessica E, Suh Insoo, Duh Quan-Yang
Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Surgery, University Medical Center, Utrecht, Netherland.
J Surg Oncol. 2018 May;117(6):1217-1222. doi: 10.1002/jso.24961. Epub 2018 Jan 8.
Genetic testing for pheochromocytoma and paraganglioma allows for early detection of hereditary syndromes and enables close follow-up of high-risk patient. We investigated the trends in genetic testing among patients at a high-volume referral center and evaluated the prevalence of pheochromocytomas and paragangliomas.
We reviewed the charts of 129 patients who underwent adrenalectomy for pheochromocytoma and paraganglioma between January 2000 and July 2015. To evaluate for trends in genetic testing, patients were divided by year of diagnosis: 2000-2005 (group 1, n = 35), 2006-2010 (group 2, n = 44), and 2011-2015 (group 3, n = 50).
Among 129 patients the mean age was 47 years and 56% were women. Groups 2 and 3 were more frequently referred for genetic consultation than group 1, 73%, and 94% versus 26% (P < 0.001). A total of 67% followed up on the referral. The prevalence of genetic mutation was 50% (21/42 tested). The percentage with a genetic syndrome was 23%, 28%, and 22% respectively for groups 1, 2, and 3.
Referral for genetic counseling significantly increased in the past 15 years. However, only two-thirds of patients followed up with genetic counselors and, therefore, clinicians can do more to improve the adherence rate for genetic counseling.
嗜铬细胞瘤和副神经节瘤的基因检测有助于早期发现遗传性综合征,并能对高危患者进行密切随访。我们调查了一家大型转诊中心患者的基因检测趋势,并评估了嗜铬细胞瘤和副神经节瘤的患病率。
我们回顾了2000年1月至2015年7月期间129例因嗜铬细胞瘤和副神经节瘤接受肾上腺切除术患者的病历。为评估基因检测趋势,根据诊断年份将患者分为:2000 - 2005年(第1组,n = 35),2006 - 2010年(第2组,n = 44),以及2011 - 2015年(第3组,n = 50)。
129例患者的平均年龄为47岁,56%为女性。第2组和第3组比第1组更频繁地被转诊进行基因咨询,分别为73%、94%和26%(P < 0.001)。总共67%的患者遵循了转诊建议。基因突变的患病率为50%(42例检测中有21例)。第1组、第2组和第3组患有遗传综合征的比例分别为23%、28%和22%。
在过去15年中,转诊进行遗传咨询的情况显著增加。然而,只有三分之二的患者与遗传咨询师进行了随访,因此,临床医生可以采取更多措施来提高遗传咨询的依从率。