van Heerden J A, Sheps S G, Hamberger B, Sheedy P F, Poston J G, ReMine W H
Surgery. 1982 Apr;91(4):367-73.
From 1971 through 1980, 106 patients underwent operations for pheochromocytoma. Twelve patients had a pheochromocytoma as a manifestation of the multiple endocrine neoplasia type 2 syndrome. Twenty patients were found to have extra-adrenal paragangliomas. Fifteen patients (14%) had malignant tumors; eight of these tumors were encountered in the group with extra-adrenal lesions. The cumulative survival probability at 5 years was 53%. Determination of urinary metanephrines and vanillylmandelic acid were the most sensitive diagnostic aids, with accuracy rates of 95% and 89%, respectively. In recent years, the measurement of fractionated urinary and plasma catecholamine levels has greatly increased the diagnostic accuracy. Preoperative localization of pheochromocytoma has improved during the last decade. Nephrotomography, selective angiography, and venous sampling have essentially been abandoned in favor of computed tomography. With an accuracy of more than 90%, computed tomography represents the major step forward in the overall management of pheochromocytoma during the past decade.
1971年至1980年期间，106例患者接受了嗜铬细胞瘤手术。12例患者的嗜铬细胞瘤是多发性内分泌肿瘤2型综合征的一种表现。20例患者被发现患有肾上腺外副神经节瘤。15例患者（14%）患有恶性肿瘤；其中8例肿瘤出现在肾上腺外病变组。5年累计生存概率为53%。测定尿间甲肾上腺素和香草扁桃酸是最敏感的诊断辅助手段，准确率分别为95%和89%。近年来，测定尿和血浆中去甲肾上腺素、肾上腺素、多巴胺的水平极大地提高了诊断准确性。过去十年中，嗜铬细胞瘤的术前定位有了改善。肾断层扫描、选择性血管造影和静脉采样基本上已被放弃，转而采用计算机断层扫描。计算机断层扫描的准确率超过90%，代表了过去十年中嗜铬细胞瘤整体治疗的重大进展。
