论文部分内容阅读
目的探讨初发恶性嗜铬细胞瘤与复发恶性嗜铬细胞瘤患者术中情况及预后的不同特征。方法回顾性分析嗜铬细胞瘤患者284例,将病理诊断为生物学恶性潜能及发生远处转移的32例嗜铬细胞瘤患者纳入研究。将32例患者分为两组:初发恶性嗜铬细胞瘤组17例,复发恶性嗜铬细胞瘤组15例。对两组患者基线资料、术中情况及预后特征进行比较和分析。结果病理诊断为生物学恶性的患者,与有远处转移的患者比较,基线资料一致,但预后显著优于后者(P=0.015)。复发恶性嗜铬细胞瘤患者行毗邻器官切除术及减瘤手术的风险显著高于初发恶性嗜铬细胞瘤患者(P=0.023,P=0.016)。术后随访结果显示:复发恶性嗜铬细胞瘤患者的预后均显著差于初发恶性嗜铬细胞瘤患者(P=0.029,P=0.025),并与肿瘤具有生物学恶性潜能或已发生转移性病变无显著关联。结论手术仍是恶性嗜铬细胞瘤的主要治疗方式;与初发恶性嗜铬细胞瘤患者相比,复发恶性患者手术风险增加,预后更差。
Objective To investigate the different characteristics of intraoperative status and prognosis of patients with newly diagnosed malignant pheochromocytoma and recurrent malignant pheochromocytoma. Methods A retrospective analysis of 284 cases of pheochromocytoma patients, pathological diagnosis of biological malignant potential and the occurrence of distant metastases in 32 patients with pheochromocytoma included. 32 patients were divided into two groups: 17 cases of malignant pheochromocytoma group and 15 cases of recurrent malignant pheochromocytoma group. The baseline data, intraoperative status and prognosis of the two groups were compared and analyzed. Results The patients with pathologically diagnosed malignant tumors had the same baseline data as the patients with distant metastases but the prognosis was significantly better than the latter (P = 0.015). Patients with recurrent malignant pheochromocytoma had a significantly higher risk of adjuvant organ resection and tumor reduction than those with initial malignant pheochromocytoma (P = 0.023, P = 0.016). The postoperative follow-up results showed that the prognosis of patients with recurrent malignant pheochromocytoma was significantly lower than that of the patients with newly diagnosed malignant pheochromocytoma (P = 0.029, P = 0.025). The prognosis of recurrent malignant pheochromocytoma was significantly higher than that of malignant pheochromocytoma Lesions no significant correlation. Conclusions Surgery is still the main treatment for malignant pheochromocytoma. Compared with newly diagnosed patients with malignant pheochromocytoma, the surgical risk of recurrent malignant patients is increased, and the prognosis is worse.