原发与复发转移性嗜铬细胞瘤/副神经节瘤的临床特征对比分析

Comparison and analysis of clinic features of primary and recurrent/metastatic phaeochromocytoma/paraganglioma

目的分析原发与复发转移性嗜铬细胞瘤/副神经节瘤(PPGL)患者的临床特征差异,以改善复发转移性患者的预后。方法收集2011年6月至2021年6月我院各科室收治的107例PPGL患者资料并随诊;对比原发与复发移性PPGL患者,以及对比复发转移性嗜铬细胞瘤与副神经节瘤患者的有关临床指标,并行统计分析。结果大于5 cm的肿瘤、肿瘤内坏死/液化、CgA强阳性(++)及Ki-67指数>5%的复发/转移性PPGL患者比例,显著高于原发性PPGL的比例,差异有统计学意义(P<0.05)。与复发/转移性嗜铬细胞瘤相比,复发/转移性副神经节瘤更大、更易液化坏死,CgA强阳性和Ki-67指数>5%的比例更高(P<0.05)。结论大于5 cm的肿瘤、肿瘤内液化坏死、Ki67指数高以及CgA强阳性的PPGL患者,发生复发/转移的可能性大;相对于嗜铬细胞瘤,副神经节瘤的患者更易出现复发和转移,其预后也更差。

Objective In order to improve the prognosis of recurrent and metastatic phaeochromocytoma/paraganglioma(PPGL),analysis of clinic features of primary and recurrent/metastatic PPGL.Methods A total of 107 cases of PPGL in our hospital were recruited from Jun 2010 to Jun 2021.Clinic features of primary PPGL and recurrent/metastatic PPGL,and those of recurrent/metastatic phaeochromocytoma and recurrent/metastatic paraganglioma were compared and analyzed statistically.Results The patient proportion of tumor>5 cm in diameter、tumor necrosis and liguefaction、strong positive CgA and>5%Ki-67 index in recurrent/metastatic PPGL were statistically higher than those in primary PPGL(P<0.05).Compared with recurrent/metastatic phaeochromocytoma,recurrent/metastatic paraganglioma were lager,leading to necrosis and liguefaction more easily,and the patient proportion of strong positive CgA and>5%Ki-67 index were statistically higher(P<0.05).Conclusion Patient of the PPGL with tumor>5 cm in diameter,tumor necrosis and liguefaction,strong positive CgA and>5%Ki-67 index,become more recurrent and metastatic likely.Compared with phaeochromocytoma,paraganglioma is more recurrent and metastatic easily with poorer prognosis.