嗜铬细胞瘤发现方式的临床特征比较分析

A comparative analysis of clinical characteristics in pheochromocytoma detection

目的探索和比较肾上腺偶发嗜铬细胞瘤与症状导向型嗜铬细胞瘤患者的临床特征。方法回顾性分析2017年5月—2023年5月北京大学第一医院收治的227例肾上腺嗜铬细胞瘤患者,收集并比较患者的一般资料、诊断模式、症状特点、肿瘤大小、手术情况等资料。结果肾上腺偶发嗜铬细胞瘤患者共129例(56.8%),症状导向型嗜铬细胞瘤患者74例(32.6%),基因突变患者10例,术后复发患者9例,恶性肿瘤随访和全身评价过程中发现5例。与症状导向型嗜铬细胞瘤患者比较,肾上腺偶发嗜铬细胞瘤患者在典型症状及非特异性症状发生率、高血压发生率、阵发性高血压比例、血压峰值、联合肾脏切除比例方面差异有统计学意义(P<0.05)。二者在性别、年龄、体重指数(BMI)、肿瘤位置及肿瘤大小方面比较差异无统计学意义(P>0.05)。结论由于健康体检与影像学技术的普及,嗜铬细胞瘤的诊断模式正逐渐改变,需要提高大众健康意识来改善嗜铬细胞瘤的诊断和治疗。

Objective To explore and compare the clinical characteristics of incidental adrenal pheochromocytoma and symptom-guided pheochromocytoma patients.Methods A retrospective analysis was conducted on 227 patients with pheochromocytoma treated at Peking University First Hospital from May 2017 to May 2023.Patient demographics,diagnostic patterns,symptom characteristics,tumor sizes,and surgical outcomes were collected and compared.Results Among the 227 cases,there were 129 cases(56.8%)of incidental adrenal pheochromocytoma and 74 cases(32.6%)of symptom-guided pheochromocytoma.There were 10 cases with genetic mutations,9 cases of postoperative recurrence,and 5 cases detected during follow-up and systemic evaluation with malignant tumors.Statistically significant differences were observed between incidental adrenal pheochromocytoma and symptom-guided pheochromocytoma in terms of the occurrence of typical and non-specific symptoms,the incidence of hypertension,the proportion of paroxysmal hypertension,peak blood pressure values,and the rate of combined renal resection(P<0.05).There were no statistically significant differences between the two groups in terms of gender,age,BMI,tumor location,and tumor size(P>0.05).Conclusion With the increasing prevalence of health caring and advances in imaging technology,the diagnostic patterns of pheochromocytoma are gradually changing.It is necessary to raise public awareness of health to improve the diagnosis and treatment of pheochromocytoma.