肾上腺皮质癌诊治方法的探讨

Adrenal cortical carcinoma

目的探讨肾上腺皮质癌的诊断和治疗方法。方法回顾１９７８年～１９９８年收治的１５例肾上腺皮质癌，其中有内分泌功能８例，无内分泌功能７例，均经手术和病理证实。结果有内分泌功能性肾上腺皮质癌具有典型肾上腺皮质功能增强的临床表现，如库兴综合征、原发性醛固酮增多症或性征异常；无内分泌功能性肿瘤为腺外表现：如急性腹痛、高血压等。尿１７羟、１７酮和血、尿皮质醇、醛固酮的测定及ＣＴ和Ｂ超检查均有助于诊断。结论手术是唯一有效的治疗方法。肿瘤早期诊断困难，特别是无功能性肿瘤，因而预后差。

Objective To study the diagnosis and treatment of adrenal cortical carcinoma. MethodsBZFifteen cases of adrenal cortical carcinoma (8 functional and 7 nonfunctional) were treated surgically during the period of 19781998. They were confirmed operatively and pathologically. Results The functional carcinoma usually showed typical clinical features such as Cushings syndrome, primary aldosteronism, and adrenogenital syndrome. The nonfunctional had extraadrenal symptoms such as actue abdominal pain and hypertension.A definite diagnosis can be made by the measurements of urine 17ketosteroid, 17hydrosteroid, cortisol, aldosterone, CT, and Bultrasonography. Conclusions Surgical removal of the tumor is the only effective treatment. Early diagnosis of adrenal cortical carcinoma is very difficult, especially in the nonfunctional.