醛固酮合酶的染色模式接受手术的原发性醛固酮含量：分类和研究临床和生化相关性的系统的建议
Staining patterns of aldosterone synthase in patients undergoing surgery for primary aldosteronism: Proposal for system of categorization and investigation of clinical and biochemical correlation
影响因子:2.70000
分区:医学2区 / 外科2区
发表日期:2025 Jan
作者:
William MacDonald, Thomas J Giordano, Joshua Leisring, Anil Parwani, Priya H Dedhia, John Phay, Lawrence S Kirschner, Barbra S Miller
摘要
醛固酮合酶（CYP11B2）染色模式如何影响单侧原发性醛固酮含量的患者结果。我们假设，一种分类系统将有益于未来的研究，并且单侧肾上腺切除术后的临床和生化结果受到不同CYP11B2染色模式的影响。对2015年1月至2023年9月至9月的原发性醛固蛋白术的肾上腺切除术的患者进行了回顾性回顾。分析了人口统计学，临床和病理数据。开发了染色模式的分类系统。将临床和生化结果与染色模式进行比较，以评估差异并确定相关性。使用SPSS进行了描述性和统计分析。舒适的三名患者。确定了以下CYP11B2染色模式：（1）单腺瘤； （2）产生结节的醛固酮或微管； （3）类型和类型2的组合； （4）增生； （5）产生醛固酮的肾上腺皮质癌。总共43个中，有23个显示CYP11B2仅在单个腺瘤中染色。在3/23中染色涉及腺瘤的一部分。 4/9岁的患者<40岁的非腺瘤组织中的CYP11B2染色区域。在43个中的37个（86％）中有37份观察到了完整的生化疗法，并在23.2％中完全治愈。染色模式与性别，种族或年龄之间没有差异。 CYP11B2染色模式与早期临床或生化结局无关。接受原发性醛固酮症治疗的患者的肾上腺切除术标本显示多种CYP11B2染色模式，包括许多患者的非腺形组织。这些模式对临床结果的影响需要进行额外的研究。染色模式的统一分类将允许在研究之间进行一致的报告。
Abstract
How aldosterone synthase (CYP11B2) staining patterns impact patient outcomes in those with unilateral primary aldosteronism is not well described. We hypothesized that a system of categorization would benefit future research and that clinical and biochemical outcomes after unilateral adrenalectomy are impacted by different CYP11B2 staining patterns.A retrospective review of patients undergoing adrenalectomy for primary aldosteronism from January 2015 to September 2023 was conducted. Demographics, clinical, and pathologic data were analyzed. A system of categorization of staining patterns was developed. Clinical and biochemical outcomes were compared with staining patterns to assess differences and determine correlation. Descriptive and statistical analyses were performed using SPSS.Forty-three patients were included. The following CYP11B2 staining patterns were identified: (1) single adenoma; (2) aldosterone producing nodule(s) or micronodule(s); (3) combination of type 1 and type 2; (4) hyperplasia; and (5) aldosterone-producing adrenocortical cancer. In total, 23 of 43 revealed CYP11B2 staining in a single adenoma only. Staining in 3/23 involved a portion of the adenoma. 4/9 patients age <40 had areas of CYP11B2 staining in nonadenomatous tissue. Complete biochemical cure was noted in 37 of 43 (86%) and complete clinical cure in 23.2%. There were no differences between staining pattern and sex, race, or age. CYP11B2 staining pattern did not correlate with early clinical or biochemical outcomes.Adrenalectomy specimens from patients treated for primary aldosteronism reveal multiple CYP11B2 staining patterns, including in nonadenomatous tissue in many patients. The impact of these patterns on clinical outcomes requires additional investigation. Uniform categorization of staining patterns will allow for consistent reporting across studies.