493例肾上腺大占位构成特点分析  

Analysis of the features of 493 hospitalized cases with large adrenal mass

作　　者：刘静[1,2] 臧丽 谷伟军[1] 李冰[1] 陈康[1] 裴育[1] 杜锦[1] 郭清华[1] 巴建明[1] 吕朝晖[1] 窦京涛[1] 母义明[1] Liu Jing;Zang Li;Gu Wei-Jun;Li Bing;Chen Kang;Pei Yu;Du Jin;Guo Qing-Hua;Ba Jian-Ming;Lv Zhao-Hui;Dou Jing-Tao;Mu Yi-Ming(Department of Endocrinology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Endocrinology,the People's Hospital of Longkou,Yantai,Shandong 265700,China)

机构地区：[1]解放军总医院第一医学中心内分泌科,北京100853 [2]龙口市人民医院内分泌科,山东烟台265700

出　　处：《解放军医学杂志》2022年第7期674-678,共5页Medical Journal of Chinese People's Liberation Army

摘　　要：目的总结分析肾上腺大占位的构成特点以指导临床治疗。方法回顾性分析2016年1月—2020年12月于解放军总医院第一医学中心内分泌科住院诊治的493例肾上腺占位直径≥4 cm患者的临床资料,包括性别、年龄、首诊原因、是否手术、术后病理诊断、影像学资料等。所有患者按内分泌功能评估结果分为功能性占位(n=264)与无功能性占位(n=229),按良恶性评估结果分为良性占位(n=348)与恶性占位(n=145),分析功能性占位、恶性占位所占比例及疾病谱分布情况。结果(1)493例患者就诊年龄(47.7±14.3)岁,首诊原因主要为肾上腺意外瘤(289例,58.6%)。(2)肾上腺大占位中功能性占位多于无功能性占位[53.6%(264/493)vs.46.4%(229/493)];功能性占位中嗜铬细胞瘤占比最高(65.5%),无功能性占位中髓样脂肪瘤占比最高(22.3%);功能性占位与无功能占位患者的年龄、性别、病变位置及瘤体直径差异无统计学意义。(3)肾上腺大占位中良性占位多于恶性占位[70.6%(348/493)vs.29.4%(145/493)],恶性占位瘤体直径大于良性占位[(73.85±29.84)mm vs.(67.12±26.69)mm,P<0.05];良性和恶性占位中嗜铬细胞瘤占比均居首位,分别为32.2%和42.1%;良性占位与恶性占位患者的年龄、性别、病变位置差异无统计学意义(P>0.05)。结论肾上腺占位直径≥4 cm的患者中嗜铬细胞瘤比例最高,主要以肾上腺意外瘤就诊;功能性占位多于无功能性占位,良性占位多于恶性占位;恶性占位直径更大。Objective To summarize and analyze the composition features of large adrenal mass for guiding the clinical treatment.Methods The clinical data of 493 cases of large adrenal mass(≥4 cm),admitted in the Chinese PLA General Hospital from January 2016 to December 2020,were collected and retrospectively analyzed,including gender,age,reason for first visit,operation or not,postoperative pathological diagnosis and imaging data.According to the endocrine function evaluation results,all the cases were divided into functional adrenal masses(n=264)and non-functional masses(n=229),and then,according to the tumor nature,they were divided into benign masses(n=348)and malignant masses(n=145),the spectrum of large adrenal masses were analyzed.Results(1)The mean age was(47.7±14.3)years old.Adrenal incidentalomas is the mainly reasons for first visit(n=289,58.6%).(2)Of the 493 patients reviewed,the proportion of functional adrenal masses(n=264)was higher than non-functional masses(n=229)[53.6%vs.46.4%].Pheochromocytomas occupied the highest proportion among functional masses(65.5%),Myelolipoma occupied the highest proportion among non-functional masses(22.3%).There was no significant difference in age,gender,lesion location and tumor diameter between functional masses group and non-functional masses group.(3)Of the 493 patients,the proportion of benign adrenal masses was higher than malignant masses[70.6%(348/493)vs.29.4%(145/493)].Compared with benign masses,the tumor diameter in malignant masses group was significantly larger[(73.85±29.84)mm vs.(67.12±26.69)mm,P<0.05].Pheochromocytoma occupied the first proportion in both benign(32.2%)and malignant masses(42.1%).There was no significant difference in age,gender,and lesion location between the two groups.Conclusions Among the patients with large adrenal mass(≥4 cm),pheochromocytomas occupied the highest proportion and adrenal incidentalomas was the mainly reasons for visiting doctors.Functional adrenal masses were more than non-functional adrenal masses,and benign masses w

关 键 词：肾上腺占位 嗜铬细胞瘤 髓样脂肪瘤 肾上腺皮质癌 

分 类 号：R736.6[医药卫生—肿瘤]