Precise Diagnosis, Treatment and Prognostic Evaluation of Complicated Adrenal Tumor Diseases

Study Overview
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Brief Summary
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The adrenal gland is an important organ that produces life hormones. There are many types of adrenal tumors, which tend to occur in young adults and affect the whole body. It has the dual threat: hormone secretion and tumor metastasis. At present, there are four major dilemmas in the clinical diagnosis and treatment of adrenal tumors: 1) Pulse secretion of the hormones, which are affected by many factors; and the diagnostic value of single hormone is limited; 2) Traditional imaging cannot accurately reflect the characteristics of hormone secretion. The prognosis cannot be accurately predicted; 3) The molecular characteristics of tumor cells and the microenvironment are unclear, making it difficult to implement early diagnosis and precise treatment; 4) Traditional pathology cannot determine the nature and long-term prognosis of the tumor, which makes the treatment delay, and the disease prognosis is extremely poor. It threatens the lives of patients. Starting from solving the above-mentioned key problems in the early stage, the research team has systematically established new clinical diagnostic technologies, hormone dynamic tests to accurately assess hormone secretion and segmented blood collection hormone determination technologies to accurately locate adrenal tumors; A series of important research results have been published in Science, Lancet Diabetes & Endocrinology, Cell Research, etc To sum up, the goal of this research is improving the early diagnosis rate of complicated adrenal tumors especially in malignant tumors, developing the optimal treatment plan, avoiding unnecessary surgical treatment, improving the quality of life of patients, reducing mortality. This project will further integrate the adrenal cortex and medulla hormone mass spectrometry detection and the molecular markers of adrenal tumors through phenotypic, functional imaging, and molecular pathological evaluations, and built a sensitive drug screening platform that integrates visual drug response and molecular characteristics, thereby achieving precise diagnosis and treatment of complicated adrenal tumors.

Official Title
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Precise Diagnosis, Treatment and Prognostic Evaluation of Complicated Adrenal Tumor Diseases

Conditions
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Complicated Adrenal Tumor Diseases

Intervention / Treatment
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* Other: surgery or drug


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 years old and ≤ 75 years Diagnosis of Patients with primary aldosteronism, pheochromocytoma, and cortical cancer Gender: males and females Provide written informed consent Satisfactory compliance Exclusion Criteria: Patients with renal insufficiency (Cr>2 times the upper limit of normal). Patients with a history of liver cirrhosis. Patients who are currently using corticosteroids. Patients with cardiac insufficiency (NYHA cardiac function classification grade 3 and above or EF<50%). Patients with stroke and acute myocardial infarction in the past 6 months. Patients during pregnancy and lactation

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| primary aldosteronism<br> | Other: surgery or drug<br>* pheochromocytoma and adrenocortical carcinoma need surgery and primary aldosteronism need drug according to the genetic results<br>|
| pheochromocytoma<br> | Other: surgery or drug<br>* pheochromocytoma and adrenocortical carcinoma need surgery and primary aldosteronism need drug according to the genetic results<br>|
| adrenocortical carcinoma<br> | Other: surgery or drug<br>* pheochromocytoma and adrenocortical carcinoma need surgery and primary aldosteronism need drug according to the genetic results<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| tumor biochemical marker treatment response | Complete remission (normalization of tumor markers); Partial remission (reduction of tumor markers ≥ 50%); ③No change (decrease of tumor markers <50% or increase ≤25%); ④Disease progression (tumor markers increased> 25%). | 20 years | 
| Tumor volume assessment: According to RECIST (version 1.1). | Complete response: All target lesions disappear, and the short axis of any pathological lymph nodes must be reduced to <10 mm. Partial Response: The total diameter of the target lesions is reduced by at least 30% compared with the baseline. Progressive Disease: Take the minimum value of the sum of the diameters of all target lesions measured during the study as the reference, and the relative increase in diameter sum by at least 20% ④Stable Disease: Based on the minimum value of the sum of the diameters of all target lesions measured during the study, the reduction of the target lesion did not reach PR, and the degree of increase did not reach PD, between PR and PD. | 20 years |