Histological Distribution And Clinicopathological Correlation Of Adrenal Surgery

ObjectiveHistology distribution of adrenal surgical disease at Peking Union Medical College Hospital recently 20 years. The pathological feature and differential diagnosis of adrenal tumor and the function of adrenocortical tumor.MethodSet the inclusion and exclusion criteria, collect the clinical data of adrenal surgical disease who receive surgery in PUMC/hospital between Jan 1994 to Dec 2013. The analyze adrenal surgical disease clinical date. Immunohistochemically was used to detect the expression of CgA, Melan-A,CYP11B1 and CYP11B2. Analysis the results using SPSS 22.0 software.ResultThis research was the largest cases reports on adrenal surgical disease, which including 3334 cases and 17 different diseases. The most common disease was adrenal cortical adenoma,pheochromocytoma/paraganglioma, myelolipoma, adrenal metastasis and ganglioneuroma.There are significance differences between the histopathology kinds。CgA and Melan-A could be considered as reliable immunohistochemical marks to differential diagnosis the adrenal masses from adrenal cortical or adrenal medulla. CYP11B1、CYP11B12 and KCNJ5 show a high expression on adrenal cortical-producing lesion, which can be used to diagnosis the adrenal cortical-producing lesion from others.ConclusionAdrenal surgical disease shows tremendous difference in age, gender, surgery method and hospital stay in each kind histological disease. Non-function disease was the most common type in adrenal cortical adenoma, and then were adrenal aldosterone-producing adenoma and cortical-producing adenoma. Immunohistochemical marks could differential diagnosis the adrenal masses from adrenal cortical or adrenal medulla. CYP11B1、 CYP11B12 and KCNJ5 show a high expression on adrenal cortical-producing leison. It was the first time to show the expression of KCNJ5 in cortical- producing lesion. Nonetheless, our study have some limits, the statistics difference could not equal to clinical practicability and the sample size of the immunohistochemical research are small, which means our conclusion need the father research to supported.