肾上腺转移癌28例临床诊治分析

Clinical Analysis of 28 Cases with Metastatic Adrenal Carcinoma

目的:探讨肾上腺转移癌的临床特点和诊治方法。方法:回顾性分析我院1999年6月至2005年2月收治的28例肾上腺转移癌患者的原发疾病、临床表现、诊治及预后的临床资料。结果:28例肾上腺转移癌患者的原发肿瘤中肺癌12例(42.9%)、肾癌9例(32.1%)、乳腺癌4例(14.3%)、肝癌3例(10.7%)、结肠癌2例(7.1%)、胃癌和甲状腺癌各1例(各占3.4%)。5例临床表现为腰背部压迫感、胀痛,2例乏力、消瘦。手术切除肾上腺转移癌8例,介入动脉灌注化疗及栓塞治疗7例,化疗、放疗共10例,3例放弃治疗。随访22例,随访时间至2007年12月,平均随访时间3年;手术组术后平均生存15.7个月±5.1个月,非手术组平均数生存10.3个月±4.7个月(P(0.05)。结论:肾上腺是恶性肿瘤转移的好发部位之一,肺癌是最常见的原发肿瘤,肾上腺转移癌大多数无典型的临床症状,影像学检查在肾上腺转移癌的临床诊断具有重要作用,外科手术可能延长部分患者的生存期。

Objective： To investigate the clinical features, diagnosis and treatment of the metastatic adrenal cancer. Methotis： The initial diseases, clinical features, diagnosis, treatment and prognosis of the 28 patients with metastatic adrenal carcinoma were analyzed retrospectively. Results： Lung cancer was the most common primary tumor（42.9% ）, followed by the renal cell carcinoma（32.1% ）, breast cancer（ 14. 3% ）, liver cancer（ 10.7% ）, colonic carcinoma（7.1% ）, stomach cancer and thryied carcinoma（3.4% ） . The mean survival time of 8 cases undergoing total adrenalectomy was 15.7 ± 5.1 months , longer than 10.3 ± 4.7 months which was mean survival time of patients without operation. Conclusion： Adrenal gland is a common site of metastatic carcinoma. Most patients with metastatic adrenal carcinoma have no special clinic manifestation. Ultrasonographic and CT are important diagnosis methods for metastatic adrenal carcinoma, operation is still effective and long-term survival may be achieved for those wellselected patients.