单、双侧肾上腺嗜铬细胞瘤临床特点分析

Clinical Characteristics of Bilateral and Unilateral Adrenal Pheochromocytomas

目的 总结单、双侧肾上腺嗜铬细胞瘤的临床特点和术后转归。方法 1994~2017年我院手术病理证实双侧和单侧肾上腺嗜铬细胞瘤102例,双侧13例,单侧89例,比较2组临床特点。结果 与单侧组相比,双侧组确诊时年轻[中位数30(6,69)岁vs.46(16,83)岁,Z=-2.560,P=0.010],出现头痛、大汗症状的比例高[61.5%(8/13)vs.21.3%(19/89),χ^2=7.462,P=0.006;38.5%(5/13)vs.9.0%(8/89),χ^2=6.408,P=0.011],有肾上腺肿物家族史的比例高[30.8%(4/13)vs.0%(0/89),Fisher检验,P=0.000],至少一侧为多个肿瘤的比例高[30.8%(4/13)vs.1.1%(1/89),Fisher检验,P=0.001]。结论 双侧肾上腺嗜铬细胞瘤较单侧发病年龄轻,肾上腺肿物家族史多见,临床表现更重,一侧多发肿瘤发生率高。

Objective To summarize clinical characteristics and postoperative prognosis of bilateral and unilateral adrenal pheochromocytomas.Methods A total of 102 cases of adrenal pheochromocytoma in our hospital from 1994 to 2017 were selected.There were 13 cases of bilateral and 89 cases of unilateral pheochromocytoma.Clinical characteristics of the two groups were compared.Results As compared with unilateral pheochromocytoma group,the age of onset in the bilateral group was younger[median,30(P 25=6,P 75=69)years old vs.46(P 25=16,P 75=83)years old,Z=-2.560,P=0.010],the proportion of headache and sweating was higher[61.5%(8/13)vs.21.3%(19/89),χ^2=7.462,P=0.006;38.5%(5/13)vs.9.0%(8/89),χ^2=6.408,P=0.011],the proportion of family history of adrenal masses was higher[30.8%(4/13)vs.0%(0/89),Fisher’s exact test,P=0.000],and the proportion of multiple tumors on at least one side was higher[30.8%(4/13)vs.1.1%(1/89),Fisher’s exact test,P=0.001].Conclusion Patients with bilateral adrenal pheochromocytomas have younger onset age,more family history of adrenal masses,more severe clinical manifestations and higher incidence of multiple tumors on one side than patients with unilateral lesion.