患者报告的与嗜铬细胞瘤/肝神经节瘤诊断相关的负担。

Katherine Wolf, Linda Rose-Krasnor, Stephanie Alband, Jacques W. Lenders, Lauren Fishbein
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摘要

嗜铬细胞瘤和副神经节瘤(PPGLs)分别起源于肾上腺髓质的嗜铬细胞或肾上腺外的神经嵴祖细胞。据估计,PPGL 的年发病率在 2.0-8.0/ 百万成年人之间。从患者角度来看,有关 PPGL 影响的数据极少。因此,我们从之前发表的一项关于胃肠胰神经内分泌肿瘤的研究中改编了一项调查,以探索 PPGL 患者的心声,了解改善临床护理的方法,同时了解目前存在的差距,以指导未来的研究。2022 年 6 月至 7 月期间,PPGL 患者和有遗传易感性但无 PPGL 的患者可进行自我报告的在线调查。调查问题包括社会人口学和临床特征、诊断工作、治疗和监测、护理质量和可及性以及财务影响。在此,我们报告了患者在确诊后对疾病负担的体验方面最相关的调查结果。共有 270 人做出了回应,其中大多数来自美国(79%)、白种人(88%)和女性(81%)。调查结果凸显了疾病对患者日常生活造成的负担,包括中度到重度的经济窘迫、前往专业机构的交通时间增加导致的工作和工资损失,以及严重的护理延误。受访者表示,他们的声音无人倾听,也不被认可。诊断时间的中位数仅为两年多,这对患者的身体、精神和情感都造成了巨大的伤害。增加 PPGL 专家和中心的就诊机会可加快诊断速度并改善管理,从而减轻患者和医疗中心的负担。
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Patient reported burden associated with pheochromocytoma/paraganglioma diagnosis.
Pheochromocytoma and paragangliomas (PPGLs) originate from the chromaffin cells of the adrenal medulla or neural crest progenitors outside the adrenal gland, respectively. The estimated annual incidence of PPGL is between 2.0-8.0/million adults. Minimal data exist on the impact of PPGL from the patient perspective. Therefore, a survey was adapted from a previously published study on gastroenteropancreatic neuroendocrine tumors to explore the voice of patients with PPGL and learn ways to improved clinical care while understanding the current gaps to direct future research. A self-reported online survey was available to patients with PPGL and those with genetic predisposition even without PPGL from June-July 2022. Survey questions captured sociodemographic and clinical characteristics, the diagnostic workup, treatment and monitoring, quality and access to care, and financial impact. Here, we report the most relevant findings on patient experience of disease burden following diagnosis. A total of 270 people responded, the majority of which were from the United States (79%), Caucasian (88%), and female (81%). The results of this survey highlight the burden of disease on a patient's daily life, resulting in moderate to severe financial distress, increased travel time to specialized facilities resulting in loss of work and wages, and significant delays in care. Respondents reported being unheard and unacknowledged. With a median time to diagnosis just over two years, the physical, mental, and emotional toll are substantial. Increasing access to PPGL specialists and centers could lead to faster diagnoses and better management, which may reduce the burden on both patients and healthcare centers.
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