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肾上腺意外瘤的处理:应对不确定性。

Management of adrenal incidentalomas: Working through uncertainty.

机构信息

Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France.

Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France; Inserm U1215, Neurocentre Magendie, University of Bordeaux, 146 Rue Leo Saignat, 33076 Bordeaux Cedex, France.

出版信息

Best Pract Res Clin Endocrinol Metab. 2020 May;34(3):101427. doi: 10.1016/j.beem.2020.101427. Epub 2020 May 15.

Abstract

The European society of endocrinology, in association with the European network for the study of adrenal tumors, published recommendations for the diagnosis and treatment of adrenal incidentalomas in 2016. A thorough and critical analysis of the literature was performed to establish evidence-based recommendations and expert suggestions with the aim of avoiding 'over-diagnosis' and 'over-treatment' and to reduce unnecessary investigations, surgery and follow-up. The purpose of this review is to reconsider several recommendations that are open to debate, such as imaging of adrenal incidentalomas, diagnosis of pheochromocytoma, diagnosis and treatment of autonomous cortisol-secreting tumors, investigations of bilateral AI and follow-up of non-operated AIs, based on studies published after the release of the recommendations.

摘要

2016 年,欧洲内分泌学会联合欧洲肾上腺肿瘤研究网络发布了关于肾上腺意外瘤的诊断和治疗建议。为了避免“过度诊断”和“过度治疗”,减少不必要的检查、手术和随访,我们对文献进行了全面和批判性分析,制定了基于循证医学的建议和专家意见。本综述的目的是根据发布建议后发表的研究,重新考虑一些有争议的建议,如肾上腺意外瘤的影像学检查、嗜铬细胞瘤的诊断、自主分泌皮质醇肿瘤的诊断和治疗、双侧 AI 的检查以及未手术的 AI 的随访。

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