Analysis Of Clinical Features In 68 Cases Of Pheochromocytoma And Paraganglioma

BACKGROUND:Pheochromocytomas are catecholamine-producing neuroendocrine tumours arising from chromaffin cells of the adrenal medulla or extra-adrenal paraganglia.The typical clinical symptoms are persistent paroxysmal hypertension,headache,excessive trunk sweating and palpitations.Some patients show severe anxiety,nervousness,patients with familial tendencies or accidentally discovered adrenal masses have normal blood pressure and no symptom.According to the literature,pheochromocytoma and paraganglioma are rare neuroendocrine tumours,with an annual incidence of 1/300,000,and twenty percent of them are children and adolescents.In general outpatient departments,the prevalence of PPGL patients with hypertension is 0.2-0.6%,while about 1.7%in children patients with hypertension.The prevalence of PPGL in autopsy studies that have not been diagnosed is about 0.05%-0.1%OBJECTIVE:Pheochromocytoma and paraganglioma are rare diseases of secondary hypertension.To retrospectively analyze the clinical features of pheochromocytoma and paraganglioma,comparing differences between each other.Summarize the basic characteristics,clinical manifestation,laboratory examinations,imaging examinations and pathological features and analyze the differences between two groups in order to provide evidences of diagnosing PPGL,also can early be recognized,diagnosed and treated,improving the prognosis of patients,reducing rate of metastasis,recurrence and mortality.METHODS:A total of 68 pheochromocytoma/paraganglioma cases in our hospital between January 2012 to December 2019 were analyzed retrospectively.The patients were divided into two groups---pheochromocytoma group and paraganglioma group.Then we summarized and analyzed the difference between two groups.RESULTS:There are 68 patients,of them 31 are males,which ranges from 17 to 77 years old.Besides the median onset duration is 6 months.Of a total of 68 patients,hypertension is the most common clinical feature,and the rest symptoms of PPGL occur from high to low are headache(61.8%),palpate(52.9%),sweating(52.9%),dizziness(39.7%),nausea(38.2%),chest stuffy(23.5%),abdominal pain(16.2%),and weight-losing(7.4%),syncope(7.4%),of whose episodes of headaches,sweating,palpitations(19.1%)After statistical analysis,we found that there was no significant difference between two groups in sex,age,peak of blood pressure(including systolic pressure and diastolic pressure),diameter of tumors,IGT,duration of onset,or MN/NMN.However,compared with peochromocytoma patients,paraganglioma patients more likely had albuminuria(X2=4.571,P=0.033).Besides,we found that it had a positive correlation between diameter of tumors and NMN(r=0.253,P<0.05)in PCC group,which meant the larger the tumor was,the higher the NMN would be.Besides,there was a positive correlation between MN and NMN in PCC group(r=0.272,P=0.034).In the PGL group,the onset age had a negative correlation with age(r=0.775,P=0.041).PCC and PGL had same imaging features and also pathological characteristics.CONCLUSIONAs pheochromocytoma and paraganglioma have diverse clinical manifestations and many atypical symptoms,patients’ atypical symptoms should be paid attention to clinically,and qualitative test of PPGL should be conducted when necessary.In addition,the longer the onset of PPGL,the greater the renal damage in patients,and the higher the MNs value is,the larger the pheochromocytoma may be,which provides important evidence for the preliminary screening of pheochromocytoma.