原发性肾上腺皮质癌11例临床分析  

Clinical analysis of 11 cases of primary adrenocortical carcinoma

作　　者：林乐 魏永宝 李涛 叶烈夫 朱庆国 高祥勋 Lin Le;Wei Yongbao;Li Tao;Ye Liefu;Zhu Qingguo;Gao Xiangxun.(Department of Urology,Fujian Provincial Hospital ,the Teaching Hospital of Fujian Medical University ,Fuzhou,Fujian 350001, China)

机构地区：[1]福建医科大学教学医院福建省立医院泌尿外科,福建省福州350001

出　　处：《中国基层医药》2018年第9期1103-1106,I0002,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：福建省自然科学基金资助项目（2016J05177）

摘　　要：目的 提高原发性肾上腺皮质癌诊疗水平.方法 回顾性分析11例经病理检查确诊为原发性肾上腺皮质癌患者的临床病理资料.患者中位年龄43岁,其中男性6例,女性5例;左侧7例（63.6％）;超过6 cm最大径有9例（81.8％）,平均直径12.9 cm.均完成CT和/或MRI等影像学检查,多数CT表现为混杂密度病灶,或MRI呈现混杂信号.仅3例（27.3％）术前影像学考虑肾上腺皮质癌.结果 11例患者均行手术治疗.9例（81.8％）肿瘤完整切除.3例术后失访,8例随访时间5～58个月.3例术后5～15个月肿瘤特异性死亡,美国癌症联合会/国际抗癌联盟（AJCC/UICC）分期Ⅱ期、Ⅲ期、Ⅳ期各1例.存活5例,3例无瘤生存,2例局部复发.结论 肾上腺皮质癌术前诊断困难,直径超过4 cm以及肿瘤不均匀强化,均要考虑到肾上腺皮质癌可能,应尽快手术治疗,并酌情给予化疗等综合治疗.未来基因等临床基础研究或许能够为晚期患者提供更多的治疗选择.Objective To improve the diagnosis and treatment of primary adrenal cortical carcinoma. Methods The clinical and pathological data of 11 patients who diagnosed as primary adrenal cortical carcinoma by pathology were retrospectively analyzed. The median age was 43 years ,including 6 males ,5 females. 7 cases（63.6% ） got the tumor on the left. 9 cases （81.8 % ） presented the maximum diameter of tumor more than 6 cm, and the average maximum diameter was 12.9 era. All cases had CT or MRI imaging examination. Among most of them, CT showed mixed density lesions ,or MRI showed mixed signal. Only 3 cases （27.3%） were considered adrenal cortical cancer through preoperative examinations. Results 11 patients were treated with surgical treatment. Of them, 9 cases （81.8%） had complete resection of tumor. 3 cases were lost to follow -up,while other 8 cases were followed up for 5 - 58 months. 3 cases presented tumor - sPecific death at 5 - 15 months after surgery,with each 1 case in AJCC stage H , Ⅲ and Ⅳ, respectively. Survive were in 5cases, and 3cases of them were tumor -free survival, while the other 2 cases of them had local recurrence. Conclusion Adrenal cortical carcinoma is very difficult to diagnose preoperatively. Adrenal cortical cancer should be considered when tumor size more than 4cm and tumor presenting inhomogeneous enhancement. Then, the surgical treatment should be performed as soon as possible, and as appropriate, chemotherapy and other comprehensive treatment should be given subsequently. Clinical and basic research such as genes test may provide more treatment options for advanced tumors in future.

关 键 词：肾上腺皮质肿瘤 回顾性研究 

分 类 号：R736.6[医药卫生—肿瘤]