[1]王敏 杨宇宏 孙敏.原发性醛固酮增多症的组织病理学新分类及其意义[J].国际内分泌代谢杂志,2023,43(05):372-375.[doi:10.3760/cma.j.cn121383-20220604-06010]
 Wang Min,Yang Yuhong,Sun Min..New histopathological classification of primary aldosteronism and its significance[J].International Journal of Endocrinology and Metabolism,2023,43(05):372-375.[doi:10.3760/cma.j.cn121383-20220604-06010]
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原发性醛固酮增多症的组织病理学新分类及其意义()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
43
期数:
2023年05期
页码:
372-375
栏目:
综述
出版日期:
2023-09-20

文章信息/Info

Title:
New histopathological classification of primary aldosteronism and its significance
作者:
王敏12 杨宇宏1 孙敏1
1南京医科大学第一附属医院内分泌科,南京 210029; 2南京医科大学第四附属医院内分泌科,南京 210031
Author(s):
Wang Min12 Yang Yuhong1 Sun Min1.
1Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; 2Department of Endocrinology, the Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210031, China
关键词:
原发性醛固酮增多症 免疫组化 HISTALDO共识 体细胞突变 组织病理学
Keywords:
Primary aldosteronism Immunohistochemistry HISTALDO consensus Somatic mutation Histopathology
DOI:
10.3760/cma.j.cn121383-20220604-06010
摘要:
原发性醛固酮增多症(primary aldosteronism,PA)是为数不多可以通过手术治愈的继发性高血压,其术后病理对确认诊断及评估预后具有重要意义。近年来针对醛固酮合成酶(CYP11B2)的免疫组化分析发现了多样性的PA病理表现形式,据此由多国家病理学专家组成专家组,提出了原发性醛固酮增多症的组织病理学(histopathology of primary aldosteronism,HISTALDO)国际共识,将PA病理进行了重新定义与归类。本文介绍了HISTALDO分型规则并就PA病理功能学表现与临床表型、手术转归及基因分型的相关性研究进展进行综述。
Abstract:
Primary aldosteronism(PA)is one of the few secondary hypertension that can be cured by surgery and its postoperative pathology have great significance to confirm diagnosis and evaluate prognosis. Immunohistochemical of aldosterone synthase(CYP11B2)revealed a variety of pathologic manifestations of PA in recent years, based on which the International histopathology of primary aldosteronism(HISTALDO)consensus proposed by a group of expert pathologists from many countries redefines and classifies PA pathology. This article will introduce the HISTALDO classification rules and review the research progress in the correlation between the pathological functional findings of PA and clinical phenotype, surgical outcome as well as genotyping.

参考文献/References:

[1] 中华医学会内分泌学分会.原发性醛固酮增多症诊断治疗的专家共识(2020版)[J].中华内分泌代谢杂志,2020,36(9):727-736.DOI:10.3760/cma.j.cn311282-20200615-00444.
[2] Williams TA,Lenders JWM,Mulatero P,et al.Outcomes after adrenalectomy for unilateral primary aldosteronism:an international consensus on outcome measures and analysis of remission rates in an international cohort [J].Lancet Diabetes Endocrinol,2017,5(9):689-699.DOI:10.1016/s2213-8587(17)30135-3.
[3] Williams TA,Gomez-Sanchez CE,Rainey WE,et al.International histopathology consensus for unilateral primary aldosteronism[J].J Clin Endocrinol Metab,2021,106(1):42-54.DOI:10.1210/clinem/dgaa484.
[4] Curnow KM,Tusie-Luna MT,Pascoe L,et al.The product of the CYP11B2 gene is required for aldosterone biosynthesis in the human adrenal cortex[J].Mol Endocrinol,1991,5(10):1513-1522.DOI:10.1210/mend-5-10-1513.
[5] Nishimoto K,Nakagawa K,Li D,et al.Adrenocortical zonation in humans under normal and pathological conditions[J].J Clin Endocrinol Metab,2010,95(5):2296-2305.DOI:10.1210/jc.2009-2010.
[6] Nishimoto K,Seki T,Hayashi Y,et al.Human adrenocortical remodeling leading to aldosterone-producing cell cluster generation[J].Int J Endocrinol,2016,2016:7834356.DOI:10.1155/2016/7834356.
[7] Lifton RP,Dluhy RG,Powers M,et al.A chimaeric 11 beta-hydroxylase/aldosterone synthase gene causes glucocorticoid-remediable aldosteronism and human hypertension[J].Nature,1992,355(6357):262-265.DOI:10.1038/355262a0.
[8] Gomez-Sanchez CE,Qi X,Velarde-Miranda C,et al.Development of monoclonal antibodies against human CYP11B1 and CYP11B2[J].Mol Cell Endocrinol,2014,383(1-2):111-117.DOI:10.1016/j.mce.2013.11.022
[9] De Sousa K,Boulkroun S,Baron S,et al.Genetic,Cellular,and Molecular Heterogeneity in Adrenals With Aldosterone-Producing Adenoma[J].Hypertension,2020,75(4):1034-1044.DOI:10.1161/HYPERTENSIONAHA.119.14177.
[10] Wang H,Wang F,Zhang Y,et al.Surgical outcomes of aldosterone-producing adenoma on the basis of the histopathological findings[J].Front Endocrinol,2021,12:663096.DOI:10.3389/fendo.2021.663096.
[11] Nanba K,Omata K,Gomez-Sanchez CE,et al.Genetic characteristics of aldosterone-producing adenomas in Blacks[J].Hypertension,2019,73(4):885-892.DOI:10.1161/HYPERTENSIONAHA.118.12070.
[12] 王慧萍,崔云英,马晓森,等.特发性醛固酮增多症的病理分型和手术预后[J].基础医学与临床,2021,41(10):1481-1485.DOI:10.3969/j.issn.1001-6325.2021.10.015.
[13] Omata K,Satoh F,Morimoto R,et al.Cellular and Genetic Causes of Idiopathic Hyperaldosteronism[J].Hypertension,2018,72(4):874-880.DOI:10.1161/HYPERTENSIONAHA.118.11086.
[14] Nishimoto K,Koga M,Seki T,et al.Immunohistochemistry of aldosterone synthase leads the way to the pathogenesis of primary aldosteronism[J].Mol Cell Endocrinol,2017,441:124-133.DOI:10.1016/j.mce.2016.10.014.
[15] Mete O,Erickson LA,Juhlin CC,et al.Overview of the 2022 WHO classification of adrenal cortical tumors[J].Endocr Pathol,2022,33(1):155-196.DOI:10.1007/s12022-022-09710-8.
[16] Meyer LS,Handgriff L,Lim JS,et al.Single-Center prospective cohort study on the histopathology,genotype,and postsurgical outcomes of patients with primary aldosteronism[J].Hypertension,2021,78(3):738-746.DOI:10.1161/HYPERTENSIONAHA.121.17348.
[17] Budwit-Novotny DA,Mccarty KS,Cox EB,et al.Immunohistochemical analyses of estrogen receptor in endometrial adenocarcinoma using a monoclonal antibody[J].Cancer Res,1986,46(10):5419-5425.
[18] Sun L,Jiang Y,Xie J,et al.Immunohistochemical analysis of CYP11B2,CYP11B1 and β-catenin helps subtyping and relates with clinical characteristics of unilateral primary aldosteronism[J].Front Mol Biosci,2021,8:751770.DOI:10.3389/fmolb.2021.751770.
[19] Lin JH,Peng KY,Kuo YP,et al.Aldosterone-producing nodules and CYP11B1 signaling correlate in primary aldosteronism[J].Endocrine-related cancer,2022,29(2):59-69.DOI:10.1530/erc-21-0287.
[20] Ono Y,Nakamura Y,Maekawa T,et al.Different expression of 11β-hydroxylase and aldosterone synthase between aldosterone-producing microadenomas and macroadenomas[J].Hypertension,2014,64(2):438-444.DOI:10.1161/HYPERTENSIONAHA.113.02944.
[21] Ahn CH,Na HY,Park SY,et al.Expression of CYP11B1 and CYP11B2 in adrenal adenoma correlates with clinical characteristics of primary aldosteronism[J].Clin Endocrinol(Oxf),2022,96(1):30-39.DOI:10.1111/cen.14628.
[22] Shariq OA,Mehta K,Thompson GB,et al.Primary aldosteronism:Does underlying pathology impact clinical presentation and outcomes following unilateral adrenalectomy?[J].World J Surg,2019,43(10):2469-2476.DOI:10.1007/s00268-019-05059-y.
[23] Volpe C,Hamberger B,Zedenius J,et al.Impact of immunohistochemistry on the diagnosis and management of primary aldosteronism:an important tool for improved patient follow-up[J].Scand J Surg,2020,109(2):133-142.DOI:10.1177/1457496918822622.
[24] Xie J,Zhang C,Wang X,et al.Exploration of KCNJ5 somatic mutation and CYP11B1/CYP11B2 staining in multiple nodules in primary aldosteronism[J].Front Med(Lausanne),2022,9:823065.DOI:10.3389/fmed.2022.823065.
[25] Nanba K,Yamazaki Y,Bick N,et al.Prevalence of somatic mutations in aldosterone-producing adenomas in Japanese patients[J].J Clin Endocrinol Metab,2020,105(11):e4066-4073.DOI:10.1210/clinem/dgaa595.
[26] 陈亮,宋颖,肖明,等.不同基因突变的醛固酮瘤患者的临床生化及免疫组化特征[J].中华内分泌代谢杂志,2021,37(1):45-51.DOI:10.3760/cma.j.cn311282- 20200522-00373.
[27] Omata K,Anand SK,Hovelson DH,et al.Aldosterone-producing cell clusters frequently harbor somatic mutations and accumulate with age in normal adrenals[J].J Endocr Soc,2017,1(7):787-799.DOI:10.1210/js.2017-00134.
[28] Yang Y,Gomez-Sanchez CE,Jaquin D,et al.Primary aldosteronism:KCNJ5 mutations and adrenocortical cell growth[J].Hypertension,2019,74(4):809-816.DOI:10.1161/HYPERTENSIONAHA.119.13476.

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备注/Memo

备注/Memo:
通信作者:孙敏,Email:drsunm@njmu.edu.cn
基金项目:江苏省基础研究计划自然科学基金-青年基金项目(BK20220717); 中国博士后科学基金第4批特别资助(2022TQ0132)
更新日期/Last Update: 2023-10-10