RECENT DEVELOPMENTS IN THE DIAGNOSIS AND TREATMENT OF PHEOCHROMOCYTOMA
RECENT DEVELOPMENTS IN THE DIAGNOSIS AND TREATMENT OF PHEOCHROMOCYTOMA
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DOI：
10.1016/s0025-6196(12)62113-2
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发表时间：
1990-01-01
影响因子：
8.9
通讯作者：
VANHEERDEN, JA
中科院分区：
文献类型：
--
作者：
SHEPS, SG;JIANG, NS;VANHEERDEN, JA
自从1926年梅奥诊所c.h.梅奥医生成功切除肾上腺肿瘤以来，嗜铬细胞瘤的研究和治疗一直是梅奥诊所特别关注的问题。最近的临床进展包括通过24小时动态监测检测无症状发作性高血压，通过超声心动图详细描述儿茶酚胺性心肌病，以及进一步研究卡尼三联征和其他与嗜铬细胞瘤相关的多腺体和多发性肿瘤综合征。儿茶酚胺测量解释的改进和m-[131I]碘苄基胍放射性核素扫描、计算机断层扫描和磁共振成像的发展极大地提高了我们的诊断敏锐度。抗高血压药物治疗和化疗的发展分别改善了我们对不能手术患者的儿茶酚胺分泌和肿瘤生长的管理，以及为麻醉和手术治疗做准备的患者。流式细胞术检测异常DNA直方图可能在预测肿瘤的恶性性质方面特别有用。
The investigation and management of pheochromocytoma have been of special interest at the Mayo Clinic since 1926, when Dr. C. H. Mayo successfully removed an adrenal tumor. Recent clinical developments include the detection of asymptomatic paroxysms of hypertension by 24-hour ambulatory monitoring, detailed characterization of catecholamine cardiomyopathy by echocardiography, and further experience with Carney''s triad and other polyglandular and multiple neoplasia syndromes associated with pheochromocytoma. Refinement in interpretation of catecholamine measurements and the development of radionuclide scanning with m-[131I]iodobenzylguanidine, computed tomography, and magnetic resonance imaging have greatly enhanced our diagnostic acumen. Developments in antihypertensive drug therapy and chemotherapy have improved our management of cathecholamine hypersecretion and tumor growth, respectively, in inoperable patients and in the preparation of patients for anesthesia and surgical treatment. Flow cytometry to detect abnormal DNA histograms may prove particularly useful in predicting the malignant nature of the tumors.