肾上腺意外瘤77例临床诊疗分析

Diagnosis and treatment of adrenal incidentalomas:clinical analysis of 77 cases

目的：提高肾上腺意外瘤的临床诊疗水平。方法：对2014年1月~2015年6月就诊于新疆维吾尔自治区人民医院的肾上腺意外瘤患者的临床资料进行回顾性分析。结果：患者77例,其中男34例（44.16%）,女43例（55.84%）,男∶女=1∶1.26,平均就诊年龄（50.9±12.03）岁。汉族48例,少数民族29例。77例均行手术治疗。肾上腺意外瘤患者的主要首诊原因包括常规体检27例（35.06%）、腰背部疼痛不适15例（19.48%）和腹部胀痛不适9例（11.69%）等。术后病理诊断包括肾上腺皮质腺瘤31例（40.26%）,肾上腺皮质结节状增生16例（20.77%）,嗜铬细胞瘤、肾上腺囊肿各7例（9.09%）,髓脂肪瘤5例（6.49%）,淋巴瘤、神经鞘瘤、脂肪瘤各2例（2.60%）,畸胎瘤、转移瘤、皮质腺癌、脂肪肉瘤、节细胞神经纤维瘤各1例（1.30%）。结论：肾上腺意外瘤的检出率较之前有所升高;对于年轻患者、意外瘤直径≥6cm以及确定为功能性肿瘤的患者应积极行手术治疗。

Objective：To improve the clinical diagnosis and treatment of adrenal incidentalomas.Method：All the relevant data of patients with adrenal incidentaloma admitted into People＇s Hospital of Xinjiang Uyghur Autonomous Region from January 2014 to June 2015 were retrospectively analyzed.Result：There were 77 patients including 34（44.16%）males and 43（55.84%）females with a mean age of（50.9±12.03）years old.Among these patients there were 48 Han people and 29 Ethnic people.Surgery and postoperative pathological examination were performed in all patients.Routine medical checkup,mild back discomfort and abdominal discomfort led to the discovery of adrenal incidentalomas.Postoperative pathology finally diagnosed adrenocortical adenoma in 31（40.26%）cases,adrenal nodular hyperplasia in 16（20.77%）cases,pheochromocytoma and adrenal cyst in 7（9.09%）cases respectively,myelolipoma in 5（6.49%）cases,lymphoma,cellular Schwannoma and lipoma in 2（2.60%）cases respectively,mature teratoma,metastatic tumor,adrenocortical carcinoma,adrenal liposarcoma and adrenal gland ganglioneuroma in 1（1.30%）case,respectively.Conclusion：Diagnostic level of adrenal incidentalomas has enhanced.Early surgical treatment is recommended for the young patients and adrenal incidentalomas with diameter more than 6cm and those with functional tumor.