肾上腺囊性病变的诊断及治疗经验（附99例报告）

陈吉祥; 周亮; 刘正欢; 廖邦华; 刘志洪; 陈涛; 任艳; 朱育春; 王坤杰; 李虹

doi:10.13201/j.issn.1001-1420.2020.04.004

肾上腺囊性病变的诊断及治疗经验（附99例报告）

- 1. 四川大学华西医院泌尿外科(成都, 610041);
- 2. 四川大学华西医院内分泌科

详细信息

通讯作者: 李虹,E-mail:lihonghxhx@scu.edu.cn

中图分类号: R736.6

收稿日期: 2019-10-31

Diagnosis and treatment experience of cystic adrenal lesions report of 99 cases

- 1. Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China;
- 2. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University

More Information

Corresponding author: LI Hong, E-mail: lihonghxhx@scu.edu.cn

Received Date: 31 October 2019

摘要

摘要: 目的:探究肾上腺囊性病变的临床诊治经验。方法:回顾性分析纳入我院2010年9月~2019年9月后腹腔镜术后病理诊断为肾上腺囊性病变的患者,收集患者的基本信息、CT及病理诊断等资料。结果:明确诊断的患者共计129例,其中30例因缺乏CT等重要数据被排除,最后纳入患者总数为99例。患者的平均年龄为(44.1±14.1)岁。患者均为单侧病变,其中55例病变在左侧肾上腺。28例有腰背部胀痛,31例合并高血压,术后无复发。根据患者的临床表现,可将患者分为有症状组(n=28)和无症状组(n=71)。病变>5 cm的临床表现阳性率是病变<3.5 cm的5.024倍(P=0.010)。有症状组的CT值更大(P=0.048)。根据病变的组织学分型,可分为内皮囊肿(n=33)、上皮囊肿(n=42)和其他(n=24)3组。上皮囊肿CT值更高。根据病变是否有功能,可分为有功能性囊肿(n=17)和无功能性囊肿(n=82)。结论:病变的最大径越大,患者的临床症状越明显。对于有症状的、功能性的、出血性的、可疑恶性的、潜在恶性的以及最大径>5 cm的病变,更建议手术治疗。我们单中心最常见的病变组织类型为上皮囊肿和内皮囊肿,上皮囊肿的CT值偏大。囊肿的功能性和影像学未见明显统计学相关性。
- 肾上腺囊肿 /
- 影像 /
- 组织学
Abstract: Objective: To report our experience of diagnosis and treatment of cystic adrenal lesions. Method: Patients were diagnosed as cystic adrenal lesions and received surgery in our hospital from September, 2010 to September, 2019. Their clinical history, physical examination, CT, pathology and other data were collected and reviewed. Result: Among the 129 patients, 30 patients were excluded due to lack of important data and 99 patients were finally included. Mean age was(44.1±14.1) years. Of 99 patients, 41 were males. All the patients had unilateral cystic adrenal lesions and 55 had a left cystic lesion. Twenty-eight patients complained of pain in waist and back, and 31 patients were found combined with hypertension. No recurrence was observed. On one hand, these 99 patients were divided into symptomatic group(n=28) and asymptomatic group(n=71). The positive clinical manifestations of adrenal lesions larger than 5 cm were 5.024 times that of maximum diameter less than 3.5 cm(P=0.010). Higher CT value was found in symptomatic group(P=0.048). On the other hand, according to the results of histology these 99 patients were divided into endothelial cysts(n = 33), epithelial cysts(n=42), and others(n=24). Higher CT value was found in epithelial cysts(P=0.048). Lastly, according to functional status, 17 patients were found in functional cysts group while 82 patients were found in non-functional group.Conclusion: The greater the lesion is, the more obvious the symptoms are. Surgeries are needed for cysts with symptoms, functions, hemorrhage, likelihood malignancy, potential malignancy or greater than 5 cm. The most common adrenal cysts in our institution include endothelial cysts and epithelial cysts. Larger CT value is more prone to be found in epithelial cysts. However, there was no statistic difference between functional status and iconography.
- adrenal glands cysts /
- imaging /
- histology

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