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在多重内分泌瘤2型患者群体中,部分上腺切除术用于染细胞瘤:是时候重新考虑了吗?
Diederik P D Suurd1, Medard F M Van den Broek2, Charlotte L Viëtor3
1Department of Surgical Oncology and Endocrine Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
Surgery
|June 4, 2025
概括
针对多发性内分泌新陈代谢2型染细胞瘤的部分上腺切除术具有很高的复发风险. 虽然它可以预防双边情况下的上腺功能缺陷,总上腺切除术被推作为标准方法.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 遗传学 是一个遗传学.
背景情况:
- 上腺切除术是多发性内分泌瘤2型 (MEN2) 相关的多发性内分泌瘤的标准.
- 部分上腺切除术正在研究以预防上腺功能不全,但有可能复发.
研究的目的:
- 为了确定MEN2 pheochromocytoma部分上腺切除术后的ipsilateral复发率.
- 评估双边疾病中使用部分上腺切除术预防上腺功能不充分.
主要方法:
- 追溯的多中心队列研究 (1977-2022年).
- 部分和全上腺切除术之间的复发发病率比较.
- 分析了双边手术后的无疾病生存率和上腺功能不足/危机.
主要成果:
- 部分 (n=23) 切除上腺体后复发率为30.4%,整体切除上腺体后复发率为3.1% (n=65) (P < .001).
- 平均复发时间:4年 (部分) 和21年 (总).
- 50%的双边手术患者 (至少一个部分手术) 避免使用皮质类固醇.
结论:
- 部分上腺切除术对MEN2染细胞瘤具有显著的短期复发风险.
- 建议采用全额上腺切除术作为标准,部分上腺切除术保留给特定病例.
- 部分上腺切除术在双边疾病中提供50%的避免上腺功能衰竭的机会.
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