罕见病研究2024,Vol.3Issue(1) :57-62.DOI:10.12376/j.issn.2097-0501.2024.01.008

186例结节性硬化症相关肾血管平滑肌脂肪瘤临床特点分析

The Analysis of Clinical Features of 186 Cases of Tuberous Sclerosis Complex-Associated Renal Angiomyolipoma

王旭 王文达 赵扬 王站 李亚囡 张玉石
罕见病研究2024,Vol.3Issue(1) :57-62.DOI:10.12376/j.issn.2097-0501.2024.01.008

186例结节性硬化症相关肾血管平滑肌脂肪瘤临床特点分析

The Analysis of Clinical Features of 186 Cases of Tuberous Sclerosis Complex-Associated Renal Angiomyolipoma

王旭 1王文达 1赵扬 1王站 1李亚囡 1张玉石1
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作者信息

  • 1. 中国医学科学院北京协和医院泌尿外科,北京 100730
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摘要

目的 结节性硬化症(TSC)是一种罕见的常染色体显性遗传病,可累及多个器官及系统.肾血管平滑肌脂肪瘤(RAML)是引起成人TSC患者死亡的主要原因.本研究旨在分析TSC-RAML的临床表现,使临床医师更好地认识该病在中国患者中的特点.方法 回顾性分析 2014 年 1 月至 2023 年 1 月北京协和医院TSC-RAML患者的病历资料.收集患者的年龄、性别、影像学检查、RAML分级及合并症等信息.结果 共纳入 186 例TSC-RAML患者,其中男65 例,女121 例,男女比例为1∶ 1.86.患者中位年龄为31 岁.117 例(62.9%)RAML为 6 级.22 例(11.8%)有肿瘤破裂出血史,在肿瘤破裂出血方面,高分级与低分级间存在统计学差异(P=0.0475).合并临床表现以血管纤维瘤/纤维斑块(155/186,83.3%)、室管膜下结节(103/146,70.5%)、肺淋巴管平滑肌瘤病(102/157,65.0%)、色素脱失斑(114/186,61.3%)、鲨革斑(83/186,44.6%)最为常见.其中肺淋巴管平滑肌瘤病患者均为女性(P<0.0001).结论 在TSC-RAML患者中女性患者数量相对占优.大多数TSC-RAML为 6 级,RAML分级越高,存在肿瘤破裂出血的比例越多.皮肤病变和神经系统病变为最常见的合并症.TSC相关肺淋巴管平滑肌瘤病患者均为女性.

Abstract

Objective Tuberous sclerosis complex(TSC)is a rare autosomal dominant genetic disease involving multiple organ system.Renal angiomyolipoma(RAML)is a leading cause of death for adult TSC pa-tients.Our study aims at investigating the clinical manifestations of TSC-RAML to enable clinicians to have a better understanding of the disease in Chinese patients.Methods We reviewed retrospectively the data collect-ed from patients with TSC-RAML in Peking Union Medical College Hospital from January 2014 to January 2023.We also collected information about the age,gender,imageological examination,RAML stage,and comorbidi-ties.Results A total of 186 TSC-RAML patients were registered,65 of whom were males and 121 were females(male-to-female ratio 1 ∶ 1.86).The median age of all patients was 31 years old.Totally,117 cases(62.9%)of RAML were rated stage 6.Twenty-two cases(11.8%)had a history of tumor rupture and bleed-ing.Research shows statistical differences between high and low grade on RAML rupture bleeding(P = 0.0475).Angiofibromas/fibrous cephalic plaque(155/186,83.3%),subependymal nodules(103/146,70.5%),lymphangioleiomyomatosis(102/157,65.0%),hypomelanotic macules(114/186,61.3%),and shagreen patch(83/186,44.6%)were the most common clinical manifestations.All patients with lymphangi-oleiomyomatosis(LAM)were female(P<0.0001).Conclusions Female patients predominated TSC-RAML patients.Most RAML were in stage 6.About 11.8%cases had a history of tumor rupture and hemorrhage.The higher grade meant the higher proportion of tumor rupture and hemorrhage.Dermatological and nervous lesions were the most common comorbidities.All patients with LAM in this study were female.

关键词

结节性硬化症/肾血管平滑肌脂肪瘤/临床特征/性别分布/合并症

Key words

tuberous sclerosis complex/renal angiomyolipoma/clinical features/gender distribution/comorbidities

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出版年

2024
罕见病研究

罕见病研究

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