Chen Xinlei, Hu Liru, Liu Caojie, Ni Guangcheng, Zhang Yuwei
X Chen, Endocrinology and metabolism, Sichuan University West China Hospital, Chengdu, 610041, China.
L Hu, Endocrinology and metabolism, Sichuan University West China Hospital, Chengdu, China.
Endocr Connect. 2018 Sep 1;7(11):1142-9. doi: 10.1530/EC-18-0268.
The proportion of incidentally discovered pheochromocytomas and paragangliomas(PPGL) has increased over time. However, our knowledge of them is quite limited. The purpose of this retrospective study is to generalize the commonalities in incidentally discovered PPGL, offer evidences for clinical diagnosis and management.
526 patients were included in our study after filtration from the database of West China Hospital of Sichuan University between May, 2007 and December, 2016.Among the patients, 148 of them were incidental findings and 378 of them were suspected findings. All patients' demography and tumor characteristics were recorded in detail, especially hemodynamic records and hormonal assays. The reasons for taking radiography were also collected. Most patients received preoperative medical preparation . Intraoperative and postoperative courses as well as surgical outcomes were also analyzed to identify differences between incidental findings and suspected findings.
Incidentally discovered PPGL took up 28.1% of the study population. Suspected PPGLs had a higher prevalence of hypertension, lower proportion of non-functioning PPGL, higher prevalence of MEN2 and better post-surgical blood pressure recovery than incidental finding group. However, patients in the incidental finding group showed no significant difference in preoperative blood pressure and hormonal assays with suspected findings in metaphrine and normetaphrine in plasma and urine (P>0.05).
Due to the development of technology, more PPGLs are discovered incidentally. Considering the tumor characteristics and surgical outcome, surgical decisions should be made more cautiously.
随着时间的推移,偶然发现的嗜铬细胞瘤和副神经节瘤(PPGL)的比例有所增加。然而,我们对它们的了解相当有限。这项回顾性研究的目的是归纳偶然发现的PPGL的共性,为临床诊断和管理提供依据。
从四川大学华西医院2007年5月至2016年12月的数据库中筛选出526例患者纳入本研究。其中,148例为偶然发现,378例为疑似发现。详细记录所有患者的人口统计学和肿瘤特征,特别是血流动力学记录和激素检测。还收集了进行影像学检查的原因。大多数患者接受了术前药物准备。分析术中、术后过程以及手术结果,以确定偶然发现和疑似发现之间的差异。
偶然发现的PPGL占研究人群的28.1%。疑似PPGL的高血压患病率较高,无功能PPGL的比例较低,MEN2的患病率较高,术后血压恢复情况优于偶然发现组。然而,偶然发现组患者术前血压和血浆及尿液中甲肾上腺素和去甲肾上腺素的激素检测与疑似发现组相比无显著差异(P>0.05)。
由于技术的发展,更多的PPGL被偶然发现。考虑到肿瘤特征和手术结果,手术决策应更加谨慎。