目的 分析我国西北地区成人颈动脉体瘤的流行病学表现及临床特征，为颈动脉体瘤的早期诊断及治疗提供参考依据。 方法 采取多中心、回顾性、非干预性调查方法，选择我国西北地区7所三甲医院（空军军医大学第一附属医院、兰州大学第二附属医院、甘肃省人民医院、解放军联勤保障部队第九四〇医院、青海省人民医院、宁夏医科大学总医院、宁夏回族自治区人民医院）神经外科自2011年1月1日至2023年6月30日收治的成人颈动脉体瘤患者为研究对象。收集患者的病历资料，并根据其常住地平均海拔将患者分为高海拔组（≥1 500 m）与低海拔组（<1 500 m），依据Shamblin分型将患者分为ShamblinⅠ型、Ⅱ型及Ⅲ型组，分别比较不同海拔组、不同Shamblin分型组患者间一般资料及临床特征的差异，同时采用多元有序Logistic回归分析探索颈动脉体瘤进展为ShamblinⅢ型的独立影响因素。 结果 （1）共359例患者纳入研究，其中女性276例、男性83例，年龄（48。80±12。07）岁；高海拔组211例，低海拔组148例；ShamblinⅠ型组165例，Ⅱ型组146例，Ⅲ型组48例。（2）与低海拔组相比，高海拔组患者中女性比例更高，年龄更大，汉族比例更低，ShamblinⅠ型占比更高，肿瘤体积更小，血小板计数更低，红细胞计数、红细胞压积、血红蛋白水平、血小板分布宽度、平均血小板体积、大血小板比率更高，差异均有统计学意义（P<0。05）。（3）与ShamblinⅠ型组相比，ShamblinⅢ型组患者的年龄更低、常住地海拔更低、肿瘤体积更大、发病至确诊时间间隔更长、无意间发现肿瘤而就诊比例更高、术中出血量更多以及血红蛋白水平、红细胞压积、平均红细胞体积、平均血红蛋白浓度明显降低，红细胞分布宽度变异系数、血小板计数明显升高，差异均有统计学意义（P<0。05）；与ShamblinⅡ型组相比，ShamblinⅢ型组患者的年龄更低、肿瘤体积更大、发病至确诊时间间隔更长、术中出血量更多以及血红蛋白水平、红细胞压积、平均红细胞体积明显降低，红细胞分布宽度变异系数、血小板计数明显升高，差异均有统计学意义（P<0。05）。（4）年龄（OR=0。960，95%CI：0。942~0。977，P<0。001）、常住地海拔（OR=0。992，95%CI：0。990~0。999，P=0。020）以及发病至确诊时间间隔（OR=1。009，95%CI：1。005~1。014，P<0。001）是颈动脉体瘤进展为ShamblinⅢ型的独立影响因素。 结论 我国西北地区成人颈动脉体瘤患者中女性多于男性，常住地海拔高者多于海拔低者，ShamblinⅠ型占比最高。常住地海拔高的患者中女性占比较海拔低的患者更高、年龄更大；ShamblinⅢ型患者较Ⅰ、Ⅱ型的年龄最低、常住地海拔最低、发病至确诊时间间隔最长。年龄较小、常住地海拔较低以及发病至确诊时间间隔较长的颈动脉体瘤患者更易进展为ShamblinⅢ型。 Objective To analyze the clinical and epidemiological characteristics of adult carotid body tumors (CBTs) in Northwest China to provide references for early diagnosis and treatment of CBTs。 Methods A multicenter， retrospective， non-intervention epidemiological investigation was conducted on adult CBTs patients who were hospitalized from January 1， 2011 to June 30， 2023 in 7 Class A tertiary hospitals in Northwest China (Departments of Neurosurgery， First Affiliated Hospital of Air Force Medical University， Second Affiliated Hospital of Lanzhou University， People's Hospital of Gansu Province， 940th Hospital of PLA Joint Logistic Support Force， People's Hospital of Qinghai Province， General Hospital of Ningxia Medical University， People's Hospital of Ningxia Hui Autonomous Region)。 Medical records were collected in these patients， and they were divided into 2 groups according to their average altitude residence: high altitude group (≥1 500 m) and low altitude group (<1 500 m) meanwhile， these patients were divided into Shamblin type I， type II and type III groups according to Shamblin classification criteria differences in general data and clinical features among patients from different altitude groups or Shamblin subgroups were compared。 Independent influencing factors for Shamblin type III CBTs were analyzed by multivariate ordered Logistic regression。 Results (1) A total of 359 patients were enrolled in the study， including 276 females and 83 males， aged (48。80±12。07) years 211 patients were into the high altitude group and 148 into the low altitude group 165 patients were into Shamblin type I group， 146 into Shamblin type II group， and 48 into Shamblin type III group。 (2) Compared with those in the low altitude group， patients in the high altitude group had higher proportion of females， older age， lower proportion of Han nationality， higher proportion of Shamblin type I， smaller tumor volume， lower platelet count， higher red blood cell count， hematocrit， hemoglobin level， platelet distribution width and mean platelet volume， and higher large platelet percentage， with significant differences (P<0。05)。 (3) Compared with those in the Shamblin type I group， patients in the Shamblin type III group had younger age， lower resident altitude， larger tumor volume， longer time interval from onset to diagnosis， higher proportion of unintentional tumor discovery， larger volume of intraoperative blood loss， lower hemoglobin level， hematocrit， mean erythrocyte volume， and mean hemoglobin concentration， decreased erythrocyte distribution width variable coefficient， and increased platelet count， with significant differences (P<0。05)。 Compared with those in the Shamblin type II group， patients in Shamblin type III group had younger age， larger tumor volume， longer time interval from onset to diagnosis， larger volume of intraoperative blood loss， lower hemoglobin， hematocrit and mean erythrocyte volume， higher erythrocyte distribution width variable coefficient and platelet count， with significant differences (P<0。05)。 (4) Age (OR=0。960， 95%CI: 0。942-0。977， P<0。001)， residence altitude (OR=0。992， 95%CI: 0。990-0。999， P=0。020) and time interval from onset to diagnosis (OR=1。009， 95%CI: 1。005-1。014， P<0。001) were independent influencing factors for Shamblin type III CBTs。 Conclusions More females than males are noted in patients with adult CBTs in Northwest China， and more CBTs patients live at high altitude， with Shamblin type I enjoying the highest proportion。 More female and old patients lived at high altitude is noted than those lived at low altitude patients with Shamblin type III have the youngest age， lowest altitude， and longest time interval from onset to diagnosis。 CBTs patients with young age， low residence altitude， and long time interval from onset to diagnosis are more likely to develop Shamblin type III。
Adult carotid body tumors in Northwest China: a multicenter, retrospective cross-sectional study
Objective To analyze the clinical and epidemiological characteristics of adult carotid body tumors (CBTs) in Northwest China to provide references for early diagnosis and treatment of CBTs. Methods A multicenter, retrospective, non-intervention epidemiological investigation was conducted on adult CBTs patients who were hospitalized from January 1, 2011 to June 30, 2023 in 7 Class A tertiary hospitals in Northwest China (Departments of Neurosurgery, First Affiliated Hospital of Air Force Medical University, Second Affiliated Hospital of Lanzhou University, People's Hospital of Gansu Province, 940th Hospital of PLA Joint Logistic Support Force, People's Hospital of Qinghai Province, General Hospital of Ningxia Medical University, People's Hospital of Ningxia Hui Autonomous Region). Medical records were collected in these patients, and they were divided into 2 groups according to their average altitude residence: high altitude group (≥1 500 m) and low altitude group (<1 500 m) meanwhile, these patients were divided into Shamblin type I, type II and type III groups according to Shamblin classification criteria differences in general data and clinical features among patients from different altitude groups or Shamblin subgroups were compared. Independent influencing factors for Shamblin type III CBTs were analyzed by multivariate ordered Logistic regression. Results (1) A total of 359 patients were enrolled in the study, including 276 females and 83 males, aged (48.80±12.07) years 211 patients were into the high altitude group and 148 into the low altitude group 165 patients were into Shamblin type I group, 146 into Shamblin type II group, and 48 into Shamblin type III group. (2) Compared with those in the low altitude group, patients in the high altitude group had higher proportion of females, older age, lower proportion of Han nationality, higher proportion of Shamblin type I, smaller tumor volume, lower platelet count, higher red blood cell count, hematocrit, hemoglobin level, platelet distribution width and mean platelet volume, and higher large platelet percentage, with significant differences (P<0.05). (3) Compared with those in the Shamblin type I group, patients in the Shamblin type III group had younger age, lower resident altitude, larger tumor volume, longer time interval from onset to diagnosis, higher proportion of unintentional tumor discovery, larger volume of intraoperative blood loss, lower hemoglobin level, hematocrit, mean erythrocyte volume, and mean hemoglobin concentration, decreased erythrocyte distribution width variable coefficient, and increased platelet count, with significant differences (P<0.05). Compared with those in the Shamblin type II group, patients in Shamblin type III group had younger age, larger tumor volume, longer time interval from onset to diagnosis, larger volume of intraoperative blood loss, lower hemoglobin, hematocrit and mean erythrocyte volume, higher erythrocyte distribution width variable coefficient and platelet count, with significant differences (P<0.05). (4) Age (OR=0.960, 95%CI: 0.942-0.977, P<0.001), residence altitude (OR=0.992, 95%CI: 0.990-0.999, P=0.020) and time interval from onset to diagnosis (OR=1.009, 95%CI: 1.005-1.014, P<0.001) were independent influencing factors for Shamblin type III CBTs. Conclusions More females than males are noted in patients with adult CBTs in Northwest China, and more CBTs patients live at high altitude, with Shamblin type I enjoying the highest proportion. More female and old patients lived at high altitude is noted than those lived at low altitude patients with Shamblin type III have the youngest age, lowest altitude, and longest time interval from onset to diagnosis. CBTs patients with young age, low residence altitude, and long time interval from onset to diagnosis are more likely to develop Shamblin type III.
Carotid body tumorClinical featureShamblin classificationPlateau environment
万方数据
