CAJ | 학술논문

目的提高肾上腺皮质癌的诊断及治疗水平。方法回顾性统计肾上腺皮质癌24例，其中男15例，女9例，平均年龄54岁（22～96岁），无功能性肿瘤12例，功能性肿瘤12例，表现为Cushing综合征2例，表现为原发性醛固酮增多症1例，术前均行内分泌功能、超声及CT检查。结果22例经手术治疗，完整肿瘤切除19例，另有3例因分别侵犯肝脏、胃壁及胰腺尾部难以彻底切除。术后病理Ⅰ期4例，Ⅱ期8例，Ⅲ期7例，Ⅳ期5例。随访3～70个月，平均生存23个月，9例存活至今。5例于术后局部复发，2例术后出现脑转移，3例肺转移，2例肝转移，给予联合化疗（顺铂＋多柔比星＋依托泊苷）后均未达到肿瘤缓解，术后平均生存13个月。结论肾上腺皮质癌恶性程度高、进展快、预后差、术后易复发，以根治性切除为主的综合治疗是治疗肾上腺皮质癌的有效方法。早期诊断和治疗可提高患者生存率。
목적제고신상선피질암적진단급치료수평。방법회고성통계신상선피질암24례，기중남15례，녀9례，평균년령54세（22～96세），무공능성종류12례，공능성종류12례，표현위Cushing종합정2례，표현위원발성철고동증다증1례，술전균행내분비공능、초성급CT검사。결과22례경수술치료，완정종류절제19례，령유3례인분별침범간장、위벽급이선미부난이철저절제。술후병리Ⅰ기4례，Ⅱ기8례，Ⅲ기7례，Ⅳ기5례。수방3～70개월，평균생존23개월，9례존활지금。5례우술후국부복발，2례술후출현뇌전이，3례폐전이，2례간전이，급여연합화료（순박＋다유비성＋의탁박감）후균미체도종류완해，술후평균생존13개월。결론신상선피질암악성정도고、진전쾌、예후차、술후역복발，이근치성절제위주적종합치료시치료신상선피질암적유효방법。조기진단화치료가제고환자생존솔。
Objective To improve the capability of diagnosing and treating adrenocortical carcinoma . Methods The clinical data of 24 cases of adrenocortical carcinoma (15 men and 9 women)were analyzed.Their age ranged from 22 to 96 years,with a mean of 54 years.Endocrinological evaluation performed in 24 patients,hormonally active tumor diagnosed were 12 of them,which usually showed typical clinical features such as Cushing′s syndrome and primary aldosteronism .Radiologic evaluations were performed in all cases , including ultrasound and CT scan . Results 19 cases underwent complete resection .There was 1 cases of pathological stage Ⅰ,8 of stage Ⅱ,7 of stageⅢand 5 of stage Ⅳ.The mean survival time was 23 months after the follow up from 3 months to 70 months,the remaining 9 cases were still alive .Locally recurrence occurred in 5 patients and metastases in 7 patients .Although chemotherapy was given , no significant response was observed , the mean survival time was 13 months. Conclusions Adrenal cortical carcinoma is a rare malignant neoplasm with poor prognosis ,surgical operation is the best way for patients ,chemotherapy and radiotherapy could be assisted and useful .Early diagnosis and management could increase the survival rate .