Characteristics of histopathology of primary aldosteronism and its impact on prognosis
10.3760/cma.j.cn311282-20240220-00068
- VernacularTitle:原发性醛固酮增多症组织病理学分型特征及其对转归的影响
- Author:
Guodong MA
1
;
Yuhong YANG
;
Meiling BAO
;
Chungao ZHOU
;
Chao QIN
;
Jun TAO
;
Min WANG
;
Yutong YAN
;
Yuqing LIU
;
Mingyu JI
;
Mei ZHOU
;
Min SUN
Author Information
1. 南京医科大学第一附属医院内分泌科，南京 210029
- Publication Type:Journal Article
- Keywords:
Primary aldosteronism;
CYP11B2 immunohistochemistry;
Pathological diagnosis;
HISTALDO consensus;
PASO criteria
- From:
Chinese Journal of Endocrinology and Metabolism
2024;40(12):1052-1058
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the histopathological features of primary aldosteronism(PA) based on the histopathology of primary aldosteronism(HISTALDO) consensus classification in patients undergoing unilateral adrenalectomy and explore its correlation with clinical characteristics and postoperative outcomes.Methods:A retrospective study was conducted on 105 unilateral PA patients treated at the First Affiliated Hospital of Nanjing Medical University between April 2017 and April 2022. Postoperative histopathology was classified according to the latest HISTALDO consensus and compared with traditional classifications. Differences in clinical features and primary aldosteronism surgical outcomes(PASO) were analyzed across classifications.Results:HISTALDO classification showed that 67.6% of patients were classical subtype and 32.4% were non-classical subtype. Compared to the non-classical group, the classical group showed lower age, body mass index, serum potassium concentration, fasting blood glucose, HbA 1C, and proportion of CYP11B2 negative nodules as well as higher systolic blood pressure, diastolic blood pressure, prevalence of hypokalemia, and 24-hour urine potassium(all P<0.05). Based on PASO criteria, complete clinical and biochemical success were achieved in 41.7% and 83.3% subjects respectively. A significantly higher proportion of classical group displayed complete clinical and biochemical success than nonclassical group(all P<0.05). Multivariate logistic regression analysis showed that lower serum potassium concentration( OR=0.15, 95% CI 0.03-0.84, P<0.05) and proportion of CYP11B2 negative nodules( OR=0.20, 95% CI 0.05-0.86, P<0.05) were related to classical pathological type, and classical pathological type was independently related to clinical and biochemical remission(all P<0.05). Conclusion:Standardized HISTALDO histopathological classification enhances diagnostic accuracy and predicts postoperative outcomes in unilateral PA, providing a foundation for precise stratified management of PA patients.
