Epidemiology of adrenal tumours in Olmsted County, Minnesota, USA: a population-based cohort study.
Epidemiology of adrenal tumours in Olmsted County, Minnesota, USA: a population-based cohort study.
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DOI：
10.1016/s2213-8587(20)30314-4
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发表时间：
2020-11
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影响因子：
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通讯作者：
Bancos I
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作者：
Ebbehoj A;Li D;Kaur RJ;Zhang C;Singh S;Li T;Atkinson E;Achenbach S;Khosla S;Arlt W;Young WF;Rocca WA;Bancos I
肾上腺肿瘤是临床上常见的肿瘤，但目前的流行病学资料主要来自转诊中心。我们的目的是确定发病率（SIR），患病率，恶性肿瘤和激素过量的标准化设置和利率。对明尼苏达州奥姆斯特德县1995年1月1日至2017年12月31日诊断为肾上腺肿瘤的所有患者进行的基于人群的研究（平均人群141，522）。SIR和患病率按2010年美国人口的性别和年龄标准化。在1,287例患者中诊断出肾上腺肿瘤（中位年龄62岁; 713例（55.4%）为女性，13例（1.0%）为儿童）。SIR从1995年的4.4（95%CI 0.3 - 8.6）/10万人年增加到2017年的47.8（95%CI 36.9 - 58.7），主要是由于40岁时偶然发现腺瘤<40mm in >。2017年肾上腺肿瘤的患病率为532/100，000居民，范围从儿童的13/100，000到65岁以上的1，900/100，000。在1,287例患者中，111例（8.6%）被诊断为恶性肿瘤（96例（7.5%）转移），14例（1.1%）为嗜铬细胞瘤，53例（4.1%）为明显的类固醇激素过量。在儿童中，（62%比8%，>18岁，P<.0001），肿瘤发现非偶然（32%对偶发瘤3%，P<.0001），肿瘤>4 cm（34% vs 7%，≤4 cm，P<·0001），肿瘤CT平扫衰减>20 Hounsfield单位（15%对1% ≤20 Hounsfield单位，P<.0001）和双侧肿块（16%对7%单侧，P=.0004）。从1995年到2017年，肾上腺肿瘤SIR增加了10倍。基于人群的数据显示恶性肿瘤、嗜铬细胞瘤和明显的类固醇激素过量的发生率比以前报道的要低。国立卫生研究院，马里兰州，美国。
Adrenal tumors are commonly encountered in clinical practice, but current epidemiological data mainly originate from referral centers. We aimed to determine incidence rates (SIR), prevalence, and rates of malignancy and hormone excess in a standardized setting. Population-based study of all patients diagnosed with adrenal tumors in Olmsted County, Minnesota, 1/1/1995–12/31/2017 (average population 141,522). SIR and prevalence were sex- and age-standardized to the 2010 US Population. An adrenal tumor was diagnosed in 1,287 patients (median age 62 years; 713 (55·4%) were women, and 13 (1·0%) were children). SIR increased from 4·4 (95%CI 0·3–8·6) per 100,000 person-years in 1995 to 47·8 (95%CI 36·9–58·7) in 2017, mainly due to incidental discovery of adenomas <40mm in >40-year-olds. Prevalence of adrenal tumors in 2017 was 532/100,000 inhabitants, ranging from 13/100,000 in children to 1,900/100,000 among >65-year-olds. Of 1,287 patients, 111 (8·6%) were diagnosed with malignancy (96 (7·5%) metastases), 14 (1·1%) with pheochromocytoma, and 53 (4·1%) with overt steroid hormone excess. Malignancy was more common in children (62% vs 8% in >18-year-olds, P<·0001), tumors discovered non-incidentally (32% vs 3% in incidentalomas, P<·0001), tumors >4 cm (34% vs 7% in ≤4 cm, P<·0001), tumors with unenhanced CT attenuation >20 Hounsfield units (15% vs 1% for ≤20 Hounsfield units, P<·0001), and bilateral masses (16% vs 7% for unilateral, P=·0004). Adrenal tumor SIR increased 10 times from 1995 to 2017. Population-based data revealed lower rates of malignancy, pheochromocytoma, and overt steroid hormone excess than previously reported. National Institutes of Health, Maryland, USA.