肾上腺皮质癌临床病理特征及影响切除术后复发再手术患者的预后因素分析

doi:10.3969/j.issn.1671-7171.2023.04.016

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Abstract 【Objective】 To explore the clinicopathological characteristics of adrenocortical carcinoma (ACC) and factors affecting the prognosis of patients with recurrence after resection and reoperation. 【Methods】 A total of 61 patients who had recurrence after ACC resection and reoperation were followed up for 2 years. The pathological characteristics of ACC were recorded,the factors affecting the prognosis of patients with recurrence after ACC resection and reoperation were analyzed,and the Kaplan-Meier survival curve was used to calculate the survival status. 【Results】 Under the microscope,the cancer tissues were mostly arranged in nests,flakes,and strips. Pathological diagnosis showed that 2 cases had mucinous ACC,26 cases had high-grade nuclei,25 cases had pathological mitotic figures,30 cases had mitotic figures> 5,43 cases showed diffuse structure,39 cases had clear cells <25%,41 cases had vascular invasion,and 43 cases had envelope violation. Cox regression analysis showed pathological grade,ENSAT stage,lactate dehydrogenase(LDH) were independent factors affecting the overall survival rate of patients with recurrence and reoperation after ACC (P<0.05). By the end of follow-up,6 cases were lost to follow-up. Five of the 21 patients with poorly differentiated ACC who underwent recurrence and reoperation survived,20 of the 34 patients with moderately and well differentiated ACC who had recurrence and reoperation survived. The overall survival curve of patients with moderately and well differentiated ACC with recurrence and reoperation after operation was better than that of poorly differentiated patients (P<0.05). Of the 23 patients with stage Ⅲ ACC recurrence and reoperation,15 survived.Among the 32 cases patients with stage Ⅳ ACC recurrence and reoperation,10 cases survived.The overall survival curve of patients with stage Ⅲ ACC recurrence and reoperation was better than that of stage Ⅳ patients (P<0.05). Of the 26 patients with high LDH ACC recurrence and reoperation,8survived. Among the 29 patients with low LDH ACC recurrence reoperation after surgery,17 survived. The overall survival curve of patients with low LDH and recurrence after ACC reoperation was better than that of patients with high LDH (P<0.05). 【Conclusion】 The prognosis of patients with recurrence after ACC resection and reoperation is poor. The immunophenotype is helpful for pathological diagnosis. Patients with low degree of tumor differentiation,late stage,and high LDH have a high risk of poor prognosis.

Key words： Adrenal Cortex Neoplasms/SU Adrenal Cortex Neoplasms/PA Recurrence Prognosis

Received: 20 June 2022

PACS:

R736.6

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	WANG Yan-jun
	WU Li-feng

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WANG Yan-jun,WU Li-feng. Analysis of Clinicopathological Characteristics of Adrenocortical Carcinoma and Prognostic Factors in Patients with Recurrence after Resection and Reoperation[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(4): 539-542.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.04.016 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I4/539

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