腹膜后副神经节瘤的临床诊治分析  

Clinical diagnosis and treatment of retroperitoneal paraganglioma

作　　者：秦翠杰 林锐[2] 李闯 马百涛 罗云鹏 李震[1] 曹辉[1] Qin Cuijie;Lin Rui;Li Chuang;Ma Baitao;Luo Yunpeng;Li Zhen;Cao Hui(Department of Endovascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院腔内血管外科,郑州450052 [2]郑州大学第一附属医院消化内科,郑州450052

出　　处：《中华普通外科杂志》2023年第12期889-893,共5页Chinese Journal of General Surgery

摘　　要：目的分析腹膜后副神经节瘤(paraganglioma,PGL)的临床病理特征、治疗及预后。方法回顾性分析2015年1月—2022年1月就诊于郑州大学第一附属医院65例腹膜后PGL患者的临床病理及随访资料。结果功能性PGL患者较非功能性PGL患者入院收缩压和舒张压水平更高,差异具有统计学意义(180 mmHg比140 mmHg,Z=-4.807,P<0.001;100 mmHg比82 mmHg,Z=-4.495,P<0.001),术中更易出现血流动力学不稳定(χ^(2)=8.188,P=0.004)。65例患者均接受手术治疗,1例行下腔静脉离断,其余患者无重要血管重建。术后共随访62例患者,因病情进展死亡4例,5年生存率为92%。G3级肿瘤和肿瘤远处转移患者预后更差(χ^(2)=4.259,P=0.039;χ^(2)=13.061,P<0.001)。肿瘤直径和肿瘤功能状态与患者预后无关(χ^(2)=0.519,P=0.472;χ^(2)=0.010,P=0.920)。结论腹膜后PGL较少见,部分可累及腹部大血管;手术完整切除肿瘤后预后较好;肿瘤发生远处转移和G3级别肿瘤与患者的不良预后有关。Objective To analyze the clinical features,treatment,pathology and prognosis of retroperitoneal paraganglioma(PGL).Methods Surgery adopted,pathology and follow-up data of patients with retroperitoneal PGL at the First Affiliated Hospital of Zhengzhou University from Jan 2015 to Jan 2022 were retrospectively analyzed.Results Compared with non-functional PGL patients,those with functional PGL had higher systolic and diastolic blood pressure(180 mmHg vs.140 mmHg,Z=-4.807,P<0.001;100 mmHg vs.82 mmHg,Z=-4.495,P<0.001)at admission,and were more prone to hemodynamic instability during operation(χ^(2)=8.188,P=0.004).All 65 patients under wentresection,with partial excision and repair of inferior vena cava in 1 patient.Sixty-two patients out of 65 were followed up,and 4 patients died of disease progression.The overall 5-year survival rate was 92%.The prognosis of patients with G3 tumor and distant metastasis was poor,the difference was statistically significant(χ^(2)=4.259,P=0.039;χ^(2)=13.061,P<0.001).Tumor diameter and tumor functional status were not related to the prognosis,and the difference was not statistically significant(χ^(2)=0.519,P=0.472;χ^(2)=0.010 P=0.920).Conclusions Retroperitoneal PGL is less common,and some may encroach abdominal large vessels.The prognosis is good after complete resection of the tumor.Distant metastasis and G3 tumors are associated with poor prognosis.

关 键 词：副神经节瘤 高血压 预后 

分 类 号：R735.4[医药卫生—肿瘤]