【摘要】 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。更多还原

【Abstract】 Objective To explore the differences of intraoperative conditions and prognosis between patients with primary malignant pheochromocytomas(pheos) and recurrent malignant pheos.Methods A total of 284 cases of pheos were retrospectively analyzed and 32 cases that were pathologically diagnosed with biological malignance or metastasis were included in the study and divided into the primary malignant pheos group(n = 17)and recurrent malignant pheos group(n=15).Baseline characteristics,intraoperative conditions,and prognosis of two groups were compared and analyzed.Results Compared with patients pathologically diagnosed with metastasis,baseline characteristics of patients pathologically diagnosed with biological malignance were similar,while the prognosis was much better(P = 0.015).The risk of surrounding organs excision and debulking surgery of patients with recurrent malignant pheos was significantly higher than that of patients with primary malignant pheos(P = 0.023,P=0.016).Results of postoperative follow-ups showed that the prognosis of patients with recurrent malignant pheos was significantly worse than that of patients with primary malignant pheos(P = 0.029,P = 0.025) and the prognosis was not significantly correlated with biological malignance or metastasis.Conclusion Surgical removal is still the main treatment for malignant pheos.Compared with patients with primary malignant pheos,the operation risk of patients with recurrent malignant pheos increases and the prognosis is worse.更多还原