不同年龄段嗜铬细胞瘤患者临床病理特点及围术期临床特征分析

Clinicopathological and perioperative clinical characteristics of patients with pheochromocytoma of different ages

摘要:

目的 探寻不同年龄段之间嗜铬细胞瘤患者的临床病理特点及围术期临床特征，为临床嗜铬细胞瘤患者个体化治疗提供更多的理论基础。方法 回顾性收集2012年至2022年入住重庆医科大学附属第一医院经病理证实且接受手术治疗的213例嗜铬细胞瘤患者的临床病理特征及围术期资料，根据年龄差异分成青年、中年、老年3组。并对3组嗜铬细胞瘤患者的临床病理指标及围术期特征进行比较分析。结果 病灶大小、术中出血量、体质指数、术前合并症、入院症状、术中血压波动及病理特征的分布在3组间差异均有统计学意义（P<0.05）。其中，老年患者病灶直径最大，术后活检病理特征为NSE阳性的比例最高，且术后更易出现营养相关性并发症；青年组增殖细胞核抗原（proliferation cell nuclear antigen，Ki-67）阳性率最高，在入院时伴发嗜铬细胞瘤相关症状的比例最高，且易发生高血压危象和术中出血；中年组更易出现术中血压波动，但总住院时间相对较短。结论 不同年龄段嗜铬细胞瘤患者在术后并发症、入院症状、术中血压波动等方面具有差异性，因此应针对不同年龄段患者进行个体化治疗。

Abstract:

Objective To explore the clinicopathological characteristics and perioperative clinical characteristics of patients with pheochromocytoma of different ages，and to provide more theoretical bases for individualized treatment of patients with pheochromocytoma in clinical practice.Methods The clinicopathological and perioperative data of 213 patients with pheochromocytoma who were pathologically confirmed and surgically treated in our hospital from 2012 to 2022 were retrospectively analyzed，and the patients were divided into three groups according to age： youth，middle-aged，and elderly groups. The clinicopathological indices and perioperative characteristics of patients with pheochromocytoma in the three groups were compared and analyzed.Results There were significant differences in lesion size，intraoperative blood loss，body mass index，preoperative complications，admission symptoms，intraoperative blood pressure fluctuation，and pathological characteristics among the three groups（P<0.05）. The elderly group had the largest lesion diameter，the highest proportion of positive NSE in postoperative biopsy pathology，and the highest incidence of postoperative nutrition-related complications. The youth group had the highest positive rate of Ki-67，the highest proportion of pheochromocytoma-related symptoms on admission，and the highest incidence of hypertension crisis and intraoperative bleeding. The middle-aged group had the highest incidence of intraoperative blood pressure fluctuation，but shorter total length of hospital stay.Conclusion Pheochromocytoma patients of different age groups have variability in postoperative complications，admission symptoms，and intraoperative blood pressure fluctuations，so treatment should be individualized for patients of different ages.