Assessment of the risk grade of adrenal pheochromocytoma/paraganglioma and its relationship with clinicopathological parameters
Objective To investigate the clinicopathologic features of adrenal pheochromocytoma/paraganglioma(PPGLs)and evaluate the relationship between the histological risk scores and clinicopathological parameters.Methods Clinical and pathological data of 102 cases of PPGLs from January 2012 to December 2019 were collected and graded according to the Grading system for Adrenal Pheochromocytoma and Paraganglioma(GAPP)and the Grading system for Pheochromocytoma of the Adrenal Scaled Score(PASS).The relationship between the scores and clinicopathological parameters was analyzed.Results Paraganglioma consists of main and supporting cells and abundant capillaries to form characteristic organ-like structures.The size and shape of tumor cells vary slightly in different sites.Most of the tumor cells expressed neuroendocrine markers,including CgA,Syn,CD56,generally Melen-A was not expressed and S-100 was expressed.The proliferation index was generally below 5％.According to whether the tumor has recurred or metastasized,102 cases of PPGLs were divided into clinically malignant group(20 cases)and benign group(82 cases).According to the histological classification of GAPP,40(39.2％)patients were highly differentiated,55(53.9％)patients were moderately differentiated,and 7(6.9％)patients were poorly differentiated.According to the PASS score,75 cases(73.5％)were≥4points,and 27 cases(26.5％)were＜4 points.According to the PASS scoring system and the GAPP tissue grading system,tumor score and differentiation degree were closely related to the tumor site and the maximum diameter(P＜0.05).GAPP histological grading was closely related to the clinical malignancy of tumors(P＜0.05),while PASS score was not related to the clinical malignancy of tumors(P＞0.05).Both GAPP and PASS had no correlation with the patient's gender,age and clinical stage(P＞0.05).Conclusion The tumor location and maximum diameter are closely related to the risk of metastasis and recurrence of PPGLs,and GAPP score can predict the risk of tumor recurrence or metastasis.
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