未选择的筛查人群中肾上腺肿瘤的患病率及特征：一项横断面研究

Prevalence and Characteristics of Adrenal Tumors in an Unselected Screening Population : A Cross-Sectional Study.

作者信息

Jing Ying, Hu Jinbo, Luo Rong, Mao Yun, Luo Zhixiao, Zhang Mingjun, Yang Jun, Song Ying, Feng Zhengping, Wang Zhihong, Cheng Qingfeng, Ma Linqiang, Yang Yi, Zhong Li, Du Zhipeng, Wang Yue, Luo Ting, He Wenwen, Sun Yue, Lv Fajin, Li Qifu, Yang Shumin

机构信息

Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Y.J., J.H., Y.Song, Z.F., Z.W., Q.C., L.M., Y.Y., Z.D., Y.W., T.L., W.H., Y.Sun, Q.L., S.Y.).

Medical Examination Centre, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (R.L., Z.L., M.Z., L.Z.).

出版信息

Ann Intern Med. 2022 Oct;175(10):1383-1391. doi: 10.7326/M22-1619. Epub 2022 Sep 13.

DOI:10.7326/M22-1619

PMID:36095315

Abstract

BACKGROUND

With the widespread use of advanced imaging technology, adrenal tumors are increasingly being identified.

OBJECTIVE

To investigate the prevalence and characteristics of adrenal tumors in an unselected screening population in China.

DESIGN

Cross-sectional study. (ClinicalTrials.gov: NCT04682938).

SETTING

A health examination center in China.

PATIENTS

Adults having an annual checkup were invited to be screened for adrenal tumors by adrenal computed tomography.

MEASUREMENTS

The participants with adrenal tumors had further evaluation for malignancy risk and adrenal function.

RESULTS

A total of 25 356 participants were screened, 351 of whom were found to have adrenal tumors, for a prevalence of 1.4%. The prevalence increased with age, from 0.2% in participants aged 18 to 25 years to 3.2% in those older than 65 years. Among 351 participants with adrenal tumors, 337 were diagnosed with an adrenocortical adenoma, 14 with another benign nodule, and none with a malignant mass. In 212 participants with an adenoma who completed endocrine testing, 69.3% were diagnosed with a nonfunctioning adenoma, 18.9% with cortisol autonomy, 11.8% with primary aldosteronism, and none with pheochromocytoma. Proportions of nonfunctioning adenomas were similarly high in various age groups (72.2%, 67.8%, and 72.2% in those aged <46, 46 to 65, and ≥66 years, respectively).

LIMITATION

Only 212 of 337 participants with an adrenocortical adenoma had endocrine testing.

CONCLUSION

The prevalence of adrenal tumors in the general adult screening population is 1.4%, and most of these tumors are nonfunctioning regardless of patient age. Cortisol and aldosterone secretion are the main causes of functional adenomas.

PRIMARY FUNDING SOURCE

National Key Research and Development Program of China and National Natural Science Foundation of China.

摘要

背景

随着先进成像技术的广泛应用，肾上腺肿瘤越来越多地被发现。

目的

调查中国未经过选择的筛查人群中肾上腺肿瘤的患病率及特征。

设计

横断面研究。（ClinicalTrials.gov：NCT04682938）。

地点

中国一家健康体检中心。

患者

邀请进行年度体检的成年人通过肾上腺计算机断层扫描筛查肾上腺肿瘤。

测量

对患有肾上腺肿瘤的参与者进一步评估恶性风险和肾上腺功能。

结果

共筛查了25356名参与者，其中351人被发现患有肾上腺肿瘤，患病率为1.4%。患病率随年龄增长而增加，从18至25岁参与者的0.2%增至65岁以上者的3.2%。在351名患有肾上腺肿瘤的参与者中，337人被诊断为肾上腺皮质腺瘤，14人被诊断为其他良性结节，无恶性肿块。在212名完成内分泌检测的腺瘤参与者中，69.3%被诊断为无功能腺瘤，18.9%为自主性皮质醇分泌，11.8%为原发性醛固酮增多症，无嗜铬细胞瘤。无功能腺瘤在各年龄组中的比例同样较高（分别在<46岁、46至65岁和≥66岁的人群中为72.2%、67.8%和72.2%）。