Differences in clinical and pathological features between conventional adrenocortical carcinoma and oncocytic adrenocortical carcinoma
10.3760/cma.j.cn112330-20250522-00214
- VernacularTitle:传统型肾上腺皮质癌与嗜酸细胞型肾上腺皮质癌的临床及病理特征差异分析
- Author:
Jiang LIU
1
;
Zhan WANG
1
;
Songchen HAN
1
;
Yi LIU
1
;
Yang ZHAO
1
;
Jianhua DENG
1
;
Yushi ZHANG
1
Author Information
1. 中国医学科学院北京协和医学院北京协和医院泌尿外科，北京 100730
- Publication Type:Journal Article
- Keywords:
Adrenocortical carcinoma;
Conventional;
Oncocytic;
Clinical characteristics;
Pathological features
- From:
Chinese Journal of Urology
2025;46(7):523-528
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the differences in clinicopathological features and prognosis between conventional adrenocortical carcinoma（ACC）and oncocytic ACC.Methods:The clinical and pathological data of patients with conventional ACC and oncocytic ACC who were admitted to Peking Union Medical College Hospital from March 2012 to Fabruary 2025 were retrospectively analyzed. Differences in clinical and pathological characteristics between the two groups were compared. Survival curves were plotted using the Kaplan-Meier method，and differences in survival rates were compared using the log-rank test.Results:The conventional ACC group comprised 137 cases，with a mean age of（47.5 ± 12.6）years and 37.2%（51/137）being male. The oncocytic ACC group included 22 cases，with a mean age of（49.1 ± 15.3）years and 59.1%（13/22）being male. No statistically significant differences were observed in age or gender distribution between the two groups（ P > 0.05）. The conventional ACC group exhibited a significantly higher prevalence of classic Cushing’s syndrome symptoms compared to the oncocytic ACC group［35.2%（45/128）vs. 5.3%（1/19）； χ2 = 6.876， P < 0.01］. Additionally，the proportion of hypertension was higher in the conventional ACC group［49.2%（65/132）vs. 22.2%（4/18）； χ2 = 5.319， P < 0.05］，whereas the prevalence of adrenal sex characteristics was lower［22.0%（28/127）vs. 63.2%（12/19）； χ2 = 14.043， P < 0.01］. The Ki-67 proliferation index was significantly higher in conventional ACC patients［20%（10%，40%）vs. 12%（9%，20%）； Z = -2.113， P < 0.05］. Furthermore，the conventional ACC group demonstrated a lower 5-year overall survival rate than the oncocytic ACC group（44.5% vs. 67.3%， P < 0.05）. Conclusions:Conventional ACC patients have a higher proportion of Cushing’s symptoms and hypertension，and oncocytic ACC patients have a higher proportion of adrenal sexual characteristics abnormalities. The prognosis of oncocytic ACC is better than that of conventional ACC.
