肾上腺皮质腺癌(附12例报告)  

Adrenal cortical carcinoma (report of 12 cases)

作　　者：沈肖曹[1] 顾才校[1] 史时芳[2] 杜传军[1] 杨之明[1] 

机构地区：[1]浙江大学医学院附属第二医院泌尿外科,杭州310009 [2]浙江大学医学院附属第一医院泌尿外科

出　　处：《中华泌尿外科杂志》2003年第9期600-601,共2页Chinese Journal of Urology

摘　　要：目的　总结肾上腺皮质腺癌的诊治经验。　方法　分析 12例肾上腺皮质腺癌的临床特点、病理学特征及治疗预后情况。男 6例 ,女 6例。平均年龄 37岁。肿瘤均为单发 ,右侧 10例 ,左侧 2例 ;直径 3～ 30cm。Sullivan分期 :Ⅰ期 3例 ,Ⅱ期 3例 ,Ⅲ期 2例 ,Ⅳ期 4例。功能性肿瘤 4例 ,无功能性肿瘤 8例。　结果　 11例患者完整切除肿瘤 ,1例有骨转移者因肿瘤巨大 ,周围浸润 ,仅行活检。标本雌激素受体 (ER)测定 7例 ,阳性 5例。 5例分别于术后 6～ 18个月死亡 ;7例仍健康存活 ,其中 5例服用三苯氧胺。　结论　肾上腺皮质腺癌可能属性激素依赖性肿瘤 ,三苯氧胺是较有效的辅助治疗药物 ,肿瘤分期、肿瘤大小与预后密切相关。Objective To discuss the diagnosis and management of adrenal cortical carcinoma. Methods 12 cases of adrenal cortical carcinoma were evaluated with regard to clinical,pathologic characteristics and prognosis.Of the 12 patients,6 were male and 6 were female with an average age of 37.The tumor was functional in 4 and nonfunctional in 8.The tumor was on the right side in 10 and on the left in 2.The diameter of the tumor was 3～30 cm.3 cases were Sullivan stage Ⅰ,3 stage Ⅱ,2 stage Ⅲ and 4 stage Ⅳ. Results Tolal ablation of the tumor has been conducted in 11 and biopsy only in 1.Estrogen receptor expression was positive in 5 out of 7 as deteted by immunohistochemistry assay.Five patient died within 1.5 years after operation whereas the other 7 are still surviving including 5 administered with tamoxifen. Conclusions Adrenal cortical carcinoma may be an estrogen-dependant tumor,so tamoxifen is an effective adjuvant drug in the treatment.Tumor size and stage appear to be strongly correlated with prognosis,larger size and higher stage are associated with a poor prognosis.

关 键 词：肾上腺皮质肿瘤 腺癌 预后 影像学检查 手术治疗 TAM治疗 

分 类 号：R736.6[医药卫生—肿瘤]