Pathological types and clinical features of unilateral primary aldosteronism
10.3760/cma.j.cn311282-20230711-00001
- VernacularTitle:单侧原发性醛固酮增多症的病理类型分析及其临床特征
- Author:
Jiayu LI
1
;
Yi YANG
;
Linqiang MA
;
Junlong LI
;
Wenwen HE
;
Ying SONG
;
Jinbo HU
;
Shumin YANG
;
Qifu LI
;
Qianna ZHEN
Author Information
1. 重庆医科大学附属第一医院内分泌科，重庆 400016
- Keywords:
Unilateral primary aldosteronism;
Aldosterone synthase;
Pathological groups;
Prognosis
- From:
Chinese Journal of Endocrinology and Metabolism
2024;40(2):139-144
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the distribution of pathological types of unilateral primary aldosteronism, and to explore the clinical characteristics and prognosis of patients with different pathological types.Methods:A total of 241 patients with unilateral primary aldosteronism who underwent adrenal surgery were included in this study. The clinical data and postoperative follow-up data were collected, and the postoperative tissue sections were stained with HE and aldosterone synthase. According to the staining results, pathological types of 241 patients were classified, and the clinical characteristics and surgical prognosis of patients with unilateral primary aldosteronism were compared.Results:According to the international histopathology consensus for unilateral primary aldosteronism, among 241 patients with unilateral primary aldosteronism, 223 were classical(92.5%), 17 were non-classical(7.1%), and 1 was aldosterone producing carcinoma(0.4%). Among classical cases, 189 were aldosterone producing adenoma and 34 were aldosterone producing nodule. In the non-classical cases, 8 cases were multiple aldosterone producing nodule and 9 cases were multiple aldosterone producing nodule. Compared with the classical group, the non-classical group had a longer duration of hypertension(9.0 vs 5.0 years, P=0.062) and a lower baseline plasma aldosterone concentration(273 vs 305 pg/mL, P=0.147), but the difference was not significant. There was no significant difference between the two groups in the proportion of patients who achieved a complete biochemical response after surgery(98% vs 92.3%, P=0.281), but the proportion of patients who achieved a complete clinical response was significantly lower in the non-classical group(23.1% vs 52.9%, P=0.046). Conclusion:The pathological types of unilateral primary aldosteronism are predominantly classical, with aldosterone-producing adenoma being the most common. There were no significant differences in the clinical characteristics and postoperative biochemical remission rates between classical and non-classical patients, but the clinical prognosis of the latter was inferior to the former.
