Background:Adrenal incidentalomas (AI) are frequent findings in clinical practice. About 40% of AIs are associated with hypercortisolism of variable severity. Although mild autonomous cortisol secretion (MACS) has been associated with the impaired clinical outcome of several diseases, its effect on the development of benign neoplasms is unknown.Aim: To compare the prevalence of adenomas (thyroid, parathyroid, pituitary and other locations) in patients with nonfunctioning AIs (NFAIs) and MACS.Methods: A multicenter, retrospective study of patients with AIs evaluated in four tertiary hospitals was performed.Results: A total of 923 patients were included. Most patients were male (53.6%), with a mean age at diagnosis of 62.4 ± 11.13 years; 21.7% presented with bilateral AIs. MACS was observed in 29.9% (n = 276) of patients, while 69.9% (n = 647) were NFAIs. Adenomas in locations other than the adrenal gland were observed in 36% of the studied population, with a similar distribution in patients with MACS and NFAIs (33% vs. 32%;p> 0.05). There were no statistically significant differences in the prevalence of pituitary, thyroid, parathyroid or other endocrine-related adenomas between both groups, but the prevalence of metabolic comorbidities and mortality was increased in patients with MACS, specifically in patients with thyroid and other endocrine-related adenomas (p< 0.05).Conclusions: Adenomas in locations other than the adrenal glands occur in one third of patients with AIs. Mild autonomous hypercortisolism does not affect the prevalence of other endocrine-related adenomas but is associated with increased metabolic comorbidities and mortality, especially in patients with thyroid adenomas and adenomas in other locations.
背景：肾上腺偶发瘤（AI）在临床实践中较为常见。约40%的AI患者伴有不同程度的皮质醇增多症。尽管轻度自主性皮质醇分泌（MACS）与多种疾病的不良临床结局相关，但其对良性肿瘤发生发展的影响尚不明确。 目的：比较无功能肾上腺偶发瘤（NFAIs）患者与MACS患者中（甲状腺、甲状旁腺、垂体及其他部位）腺瘤的患病率。 方法：本研究为多中心回顾性研究，纳入四家三级医院收治的AI患者进行数据分析。 结果：共纳入923例患者。多数患者为男性（53.6%），诊断时平均年龄为62.4±11.13岁；21.7%为双侧AI。29.9%（n=276）的患者存在MACS，69.9%（n=647）为NFAIs。36%的研究人群存在肾上腺外腺瘤，且MACS与NFAIs患者中的分布比例相近（33% vs. 32%；p>0.05）。两组间垂体、甲状腺、甲状旁腺或其他内分泌相关腺瘤的患病率无统计学差异，但MACS患者代谢合并症患病率及死亡率显著升高，尤其在合并甲状腺腺瘤及其他内分泌相关腺瘤的患者中更为明显（p<0.05）。 结论：约三分之一的AI患者存在肾上腺外腺瘤。轻度自主性皮质醇增多症虽不影响其他内分泌相关腺瘤的患病率，但与代谢合并症及死亡率增加相关，尤其在合并甲状腺腺瘤及其他部位腺瘤的患者中更为显著。
肿瘤(癌症)患者之家