Clinical features and risk factors for postoperative recurrence in patients with Cushing's syndrome of different etiologies
Abstract The clinical characteristics of Cushing’s syndrome (CS) vary with etiology, and few studies have investigated the risk factors affecting CS recurrence after surgery. This retrospective study involved 202 patients diagnosed with CS between December 2012 and December 2022. The patients were d...
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Nature Portfolio
2024-02-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-024-53913-4 |
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| author | Yunjia Cai Xue Zhao Linan Ren Siyuan Liu Xinming Liu Xiaokun Gang Guixia Wang |
| author_facet | Yunjia Cai Xue Zhao Linan Ren Siyuan Liu Xinming Liu Xiaokun Gang Guixia Wang |
| author_sort | Yunjia Cai |
| collection | DOAJ |
| description | Abstract The clinical characteristics of Cushing’s syndrome (CS) vary with etiology, and few studies have investigated the risk factors affecting CS recurrence after surgery. This retrospective study involved 202 patients diagnosed with CS between December 2012 and December 2022. The patients were divided into three groups according to etiology: Cushing's disease (CD), adrenocortical adenoma (ACA), and ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS). Of the patients with CS, 41.9% had hypokalemia and 15.0% had hypophosphatemia. The cortisol levels were negatively correlated with blood potassium, blood chlorine, and blood phosphorus. Moreover, 22.4% of patients had an abnormal heart structure, 11.2% had centripetal remodeling, 5.6% had centripetal hypertrophy, and 5.6% had centrifugal hypertrophy. The overall recurrence rate of CS caused by pituitary tumors and adrenal adenoma was 25.7%. The recurrence times were longer in the ACA group versus the CD group, in patients < 50 years of age versus in patients ≥ 50 years old group, and in patients with CD with tumors ≥ 1 cm versus tumors < 1 cm. Age, preoperative cortisol level, postoperative cortisol level, and absolute neutrophil value were closely related to postoperative recurrence, and etiology was an independent predictor of tumor recurrence in patients with CS. The results of this study showed that CS caused by different etiologies showed different clinical manifestations, blood electrolyte characteristics, and that CS could affect patient cardiac structure and function. Etiology is an independent predictor of tumor recurrence in patients with CS. |
| first_indexed | 2024-03-07T15:02:57Z |
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| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-07T15:02:57Z |
| publishDate | 2024-02-01 |
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| spelling | doaj.art-0686d6a97c764cc2a29320a6479445c32024-03-05T19:01:44ZengNature PortfolioScientific Reports2045-23222024-02-0114111110.1038/s41598-024-53913-4Clinical features and risk factors for postoperative recurrence in patients with Cushing's syndrome of different etiologiesYunjia Cai0Xue Zhao1Linan Ren2Siyuan Liu3Xinming Liu4Xiaokun Gang5Guixia Wang6Department of Endocrinology and Metabolism, The First Hospital of Jilin UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Jilin UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Jilin UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Jilin UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Jilin UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Jilin UniversityDepartment of Endocrinology and Metabolism, The First Hospital of Jilin UniversityAbstract The clinical characteristics of Cushing’s syndrome (CS) vary with etiology, and few studies have investigated the risk factors affecting CS recurrence after surgery. This retrospective study involved 202 patients diagnosed with CS between December 2012 and December 2022. The patients were divided into three groups according to etiology: Cushing's disease (CD), adrenocortical adenoma (ACA), and ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS). Of the patients with CS, 41.9% had hypokalemia and 15.0% had hypophosphatemia. The cortisol levels were negatively correlated with blood potassium, blood chlorine, and blood phosphorus. Moreover, 22.4% of patients had an abnormal heart structure, 11.2% had centripetal remodeling, 5.6% had centripetal hypertrophy, and 5.6% had centrifugal hypertrophy. The overall recurrence rate of CS caused by pituitary tumors and adrenal adenoma was 25.7%. The recurrence times were longer in the ACA group versus the CD group, in patients < 50 years of age versus in patients ≥ 50 years old group, and in patients with CD with tumors ≥ 1 cm versus tumors < 1 cm. Age, preoperative cortisol level, postoperative cortisol level, and absolute neutrophil value were closely related to postoperative recurrence, and etiology was an independent predictor of tumor recurrence in patients with CS. The results of this study showed that CS caused by different etiologies showed different clinical manifestations, blood electrolyte characteristics, and that CS could affect patient cardiac structure and function. Etiology is an independent predictor of tumor recurrence in patients with CS.https://doi.org/10.1038/s41598-024-53913-4Cushing’s syndromeCushing’s diseaseAdrenal adenomaEctopic ACTH syndromeClinical featuresRecurrence |
| spellingShingle | Yunjia Cai Xue Zhao Linan Ren Siyuan Liu Xinming Liu Xiaokun Gang Guixia Wang Clinical features and risk factors for postoperative recurrence in patients with Cushing's syndrome of different etiologies Scientific Reports Cushing’s syndrome Cushing’s disease Adrenal adenoma Ectopic ACTH syndrome Clinical features Recurrence |
| title | Clinical features and risk factors for postoperative recurrence in patients with Cushing's syndrome of different etiologies |
| title_full | Clinical features and risk factors for postoperative recurrence in patients with Cushing's syndrome of different etiologies |
| title_fullStr | Clinical features and risk factors for postoperative recurrence in patients with Cushing's syndrome of different etiologies |
| title_full_unstemmed | Clinical features and risk factors for postoperative recurrence in patients with Cushing's syndrome of different etiologies |
| title_short | Clinical features and risk factors for postoperative recurrence in patients with Cushing's syndrome of different etiologies |
| title_sort | clinical features and risk factors for postoperative recurrence in patients with cushing s syndrome of different etiologies |
| topic | Cushing’s syndrome Cushing’s disease Adrenal adenoma Ectopic ACTH syndrome Clinical features Recurrence |
| url | https://doi.org/10.1038/s41598-024-53913-4 |
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