腹膜后嗜铬细胞瘤和副神经节瘤与交感神经节源性肿瘤的鉴别诊断  

Differential Diagnosis of Retroperitoneal Pheochromocytoma and Paraganglioma from Sympathetic Ganglion-Derived Tumors

作　　者：辛悦[1] 贾立群[1] 王玉[1] 胡艳秀[1] 王晓曼[1] Xin Yue;Jia Liqun;Wang Yu;Hu Yanxiu;Wang Xiaoman(Department of Ultrasound,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院超声科,北京市100045

出　　处：《中国超声医学杂志》2023年第8期915-917,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声对儿童腹膜后嗜铬细胞瘤和副神经节瘤(PPGL)与交感神经节源性肿瘤的鉴别诊断价值。方法回顾性收集就诊证实为腹膜后嗜铬细胞瘤和副神经节瘤病例组成PPGL组,据PPGL组瘤体大小匹配腹膜后交感神经节源性肿瘤病例组成对照组。比较两组流行病学指标及声像图特征是否有差异性,以曲线下面积(AUC)反映鉴别效能,采用二元logistic回归分析,尝试建立多因素诊断方程。结果两组病例在流行病学指标(性别、年龄)、声像图特征(回声分布、病灶钙化、病灶囊区)间的差异有统计学意义(P<0.05);其中“病灶钙化”的鉴别效能(AUC=0.866)优于“回声分布”及“病灶囊区”;联合“病灶钙化”“性别”“年龄”建立多因素诊断方程后,AUC提升至0.981,且该方程对PPGL组8例基础血压正常的PPGL患儿正确检出率达100%。结论超声可有效鉴别儿童腹膜后PPGL与交感神经节源性肿瘤,联合流行病学指标构建多因素诊断方程可进一步改善其鉴别效能。Objective To investigate the value of ultrasound in the differential diagnosis of retroperitoneal pheochromocytoma and paraganglioma(PPGL)from sympathetic ganglion-derived tumors in children.Methods The cases confirmed of retroperitoneal pheochromocytoma and paraganglioma in our hospital were retrospectively selected as the PPGL group.Cases diagnosed with retroperitoneal sympathetic ganglion-derived tumors were matched as the control group by the size of PPGL tumors.The epidemiological indexes and sonographic features of the two groups were compared,and the area under the curve(AUC)was used to reflect the discriminatory efficacy,a binary logistic regression analysis was used to construct a multifactorial diagnostic equation.Results The differences in epidemiological indicators(sex,age)and sonographic features(echogenic distribution,lesion calcification,lesion cystic area)between the two groups were statistically significant(P<0.05).The discriminatory efficacy of“lesion calcification”(AUC=0.866)was better than that of“echogenic distribution”and“lesion cystic area”.After the successful construction of a multifactorial diagnostic equation combined with“lesion calcification”,“sex”and“age”,the AUC could be further increased to 0.981.This equation could correctly detect up to 100%in the 8children of the PPGL group with normal blood pressure.Conclusions Ultrasound can effectively differentiate retroperitoneal PPGL from sympathetic ganglion-derived tumors in children,and the multifactorial diagnostic equation combined with epidemiological indicators can further improve its discriminatory efficacy.

关 键 词：嗜铬细胞瘤和副神经节瘤 交感神经节 儿童 超声 

分 类 号：R735.4[医药卫生—肿瘤]