49例成人肾上腺皮质癌临床特点、治疗现状及预后情况的回顾性分析  

A Retrospective Analysis of 49 Cases of Adult Adrenocortical Carcinoma with Clinical Features,Current Treatment Status and Prognosis

作　　者：张勃然 朱平[1] ZHANG Boran;ZHU Ping(Department of Geriatrics,The Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心老年医学科,北京100853

出　　处：《标记免疫分析与临床》2025年第1期30-33,共4页Labeled Immunoassays and Clinical Medicine

基　　金：国家重点研发计划项目(编号:2020YFC2008900)。

摘　　要：目的 总结分析成人肾上腺皮质癌患者的临床特点、治疗现状及预后情况。方法 回顾性分析2008年1月至2022年4月解放军总医院收治的肾上腺皮质癌患者的病例资料。结果 回顾性分析的49例肾上腺皮质癌患者平均年龄为47.4±13.4岁,其中男性28例,女性21例。32例行根治性手术治疗,7例行姑息性手术治疗,10例未行手术治疗。47例患者接受长期随访,中位随访时间24(4~60)个月,10例(21.28%)治愈,生存期超过5年,19例(40.43%)死亡,18例(38.30%)出现复发,复发中位时间12.5(6~36)个月。47例患者中随访2年无进展生存期(progress free survial, PFS)≥2年的患者比例为31.91%,总生存期(overall survival, OS)≥2年的患者比例为59.57%。结论 成人肾上腺皮质癌是一种罕见、具有高度侵袭性的恶性内分泌肿瘤,临床医生对其认识不足,多数患者就诊时已属晚期,预后差,总生存时间短,手术切除是主要治疗手段,部分患者采用以米托坦为主的综合治疗,临床仍需寻找更有效的治疗方案,以延长肾上腺皮质癌患者的生存时间。Objective To summarize and analyze the clinical characteristics,current treatment status and prognosis of adult patients with adrenocortical carcinoma.Methods The case data of patients with adrenocortical carcinoma admitted to the General Hospital of the People's Liberation Army from January,2008 to April,2022 were retrospectively analyzed.Results The mean age of 49 patients with adrenocortical carcinoma analyzed retrospectively was 47.4±13.4 years old,of which 28 were male and 21 were female.Thirty-two cases were treated with radical surgery,7 cases were treated with palliative surgery and 10 cases were not treated with surgery.47 patients underwent long-term follow-up with a median follow-up duration of 24(4-60)months.10 cases(21.28%)were cured with a survival period of more than 5 years,and 19 cases(40.43%)were dead,while 18 cases(38.30%)presented with recurrence with a median duration of recurrence of 12.5(6-36)months.The proportion of patients with 2-year follow-up progression free survival(PFS)≥2 years was 31.91%in 47 patients,and the proportion of patients with overall survival(OS)≥2 years was 59.57%.Conclusion Adult adrenocortical carcinoma is a rare and highly invasive malignant endocrine tumor,which is not well understood by clinicians.Most patients are in advanced stage when they visit the clinic,with a poor prognosis and short overall survival duration.Surgical resection is the main treatment,and mitochondrial-based comprehensive treatment is used in some patients,and clinics still need to find more effective treatment options to prolong the survival time of patients with adrenocortical carcinoma.

关 键 词：肾上腺皮质癌 恶性内分泌肿瘤 米托坦 综合治疗 

分 类 号：R736.6[医药卫生—肿瘤]