Clinical Characteristics And Prognosis Of 234 Cases Of Pheochromocytoma And Paraganglioma

Objective: to summarize the clinical manifestations,auxiliary examination,treatment and prognosis of 234 patients with pheochromocytoma / paraganglioma,so as to provide basis for the diagnosis and treatment of the disease.in order to improve the level of diagnosis and treatment of pheochromocytoma and paraganglioma.Methods: the patients who were hospitalized and operated in the first affiliated Hospital of Guangxi Medical University from January 1,2012 to June30,2020 and were pathologically diagnosed as pheochromocytoma/paraganglioma were analyzed retrospectively.according to the clinical diagnostic criteria,the patients were divided into pheochromocytoma group and paraganglioma group,and their clinical features,treatment and prognosis were analyzed and summarized.Results:1.Confirmed PPGL234 cases,173 cases in PCC group(73.9%),61 cases in PGL group(26.1%),PCC incidence rate in PPGL group was high.2.Compared between the two groups,the proportion of hypertension,abnormal glucose metabolism,hypertension and tumor family history in the PCC group was higher than that in the PGL group;the proportion of hypertension,chest tightness,chest pain,palpitation and shortness of breath in the PGL group was higher than that in the PGL group.In PGL group,the proportion of adrenal gland or extra-adrenal gland occupying space accidentally found by physical examination was high;most of them used open surgery;the proportion of incomplete resection of tumor was high;and the proportion of lymph node metastasis was high.The difference was statistically significant(P < 0.05).3.The results of 77 cases of perfect CA test showed that the detection rate of PPGL was low(22%～45.5%).In 21 cases of perfect NMNs,the accuracy of PPGL was(50%～76.2%).4.In partial perfect immunohistochemical PPGL,there was no significant difference in Ki-67 index,Cg A,Syn,Smur100,NSE and CD56 between the two groups.5.The recurrence rate of PPGL was 6.2%.Binary logistics regression analysis showed that family history,capsule invasion of tumor tissue and infiltration of other tissues were the risk factors of PPGL recurrence,but there was no significant difference in sex,age and tumor size.Kaplan-Meier analysis showed that tumor location,tumor tissue hemorrhage and necrosis,capsule infiltration,other tissue infiltration and metastasis were significantly correlated with DFS,but not with sex and tumor size(P > 0.05).The results of disease-free survival analysis showed that tumor location,tumor tissue hemorrhage and necrosis,capsule infiltration,other tissue infiltration and metastasis were significantly correlated with tumor location,tumor size and tumor size(P > 0.05).6.The effective rate of blood pressure control after operation was 72%,and the recovery of abnormal glucose metabolism was 76.5%.The recovery of hypertension in PCC group was better than that in PGL group,the incidence of abnormal glucose metabolism in PGL group was less than that in PCC group,and the recovery of postoperative blood glucose in PGL group was more obvious than that in PCC group.Patients with heart disease did not have related symptoms such as chest tightness,chest pain,palpitation and so on.Conclusion:1.The clinical symptoms of PPGL are changeable,often accompanied with cardiovascular and metabolic abnormalities,but with low hypertension,patients should pay attention to health management,routine screening and early intervention should be paid attention to when complicated with multi-system diseases.2.The proportion of PCC in PPGL is low,so we should pay attention to the examination of catecholamine and methoxyadrenaline in static PCC,but it is helpful to screen PPGL,but there is still a risk of missed diagnosis or misdiagnosis.3.PPGL is the first choice for surgical treatment.Hemorrhagic necrosis and capsular infiltration in PCC are higher than those in PGL,and lymph node metastasis in PGL group is higher than that in PCC group.Immunohistochemical staining of Ki-67,Cg A,Syn,Smur100 and NSE shows that most of them are positive expression,which is a good diagnostic index.4.The recurrence rate of PPGL was low.Analysis showed that family history,capsule invasion of tumor tissue and other tissue infiltration were the risk factors of recurrence of PPGL.The results showed that the location of tumor,capsule infiltration of tumor tissue,infiltration of other tissues and metastasis were related to the disease-free survival of PPGL.5.After tumor resection,the symptoms of hypertension,abnormal glucose metabolism and heart disease have been significantly improved,but there is still a risk of recurrence,but it is still necessary to pay attention to continuous followup and drug regulation to guard against recurrence and aggravation of progress.