摘要
背景与目的:中枢性神经瘤是少见的中枢神经系统肿瘤。为了提高对该病的认识、减少误诊率,我们结合文献复习,对患者的临床症状、影像学、病理改变及预后进行了研究讨论。方法:复习中国人民解放军总医院1970-2000年收治的中枢性神经瘤病例共17例,对患者的临床症状、影像学、病理改变及预后进行了回顾性研究。结果:中枢性神经细胞瘤发病率占同期原发性中枢神经系统肿瘤的0.14%。患者男10例,女7例,年龄从11岁-51岁不等,平均年龄32.7岁。肿瘤均位于脑室系统,7例位于透明隔位于侧脑室及三脑室者各5例。手术全部切除7例,部分切除10例,术后放疗者9例。9例进行了长期随访无复发迹象。另外,17例行免疫组化及2例行电镜检查,显示肿瘤呈神经元分化,仅4例局部表达GFAP;所有病例均无恶性组织学迹象,4例已做Ki-67免疫组化的阳性细胞<2%。结论:综合上述及结合文献我们认为大多数中枢性神经细胞瘤是预后良好的肿瘤,部分预后较差,增加GFAP的阳性表达、细胞增殖指数的增加以及血管的增生可能提示较差的预后。手术切除为治疗该肿瘤的较好方法。对部分切除的病例、组织学呈间变改变的病例(细胞的异形性、核分裂像增加、血管内皮细胞增生及坏死)以及增殖指数增加者应辅以放疗。
BACKGROUND ＆ OBJECTIVE： Central neurocytoma is a rare primary tumor in central nervous system. In order to get better recognition of this disease and diminish misdiagnose, our experience and literature were reviewed. We analyzed the clinical symptoms, radlological images, pathologic changes and prognosis of the patients. METHODS： Seventeen cases of central neurocytoma treated at the PLA General Hospital （Beijing） from 1970 to 2000 were analyzed for their clinical symptoms, radiological images, pathologic changes and prognosis. RESULTS： Seventeen cases of central neurocytoma consisted of approximately 0.14% of primary, central nervous system tumors treated in our hospital at the same period. The patients （10 males and 7 females） ranged in age from 11 to 57 years （mean 32.7 years）. All tumors were located in the ventricular system, which 7 were in septum pellucidum, 5 were in the left or bilateral ventricles and the other 5 were in the third ventricle. Gross total removal of the tumor was achieved in 7 cases, subtotal removal in 10 patients. Postoperative radiation was given in 9 patients. There has no evidence for recurrence in 9 patients with long follow-up. Further more. 17 cases were investigated by immunohistochemical study and 2 cases were examined under electron microscopy, which revealed that tumors appeared neuronal differentiation, and only in 4 eases have found focal positive for glial fibrillary acidic protein （GFAP）. There was no histologically malignant appearance in all the eases; Ki-67 positive rate is 〈 2% in 4 examined cases. CONCLUSION： Our result and combined the literature indicating that central neurocytomas have a favorable prognosis in general, but in some cases the clinical course could be aggressive, lncrease of GFAP positivity, proliferation index and vascular proliferation might suggest a more malignant course. The most important therapeutic modality is surgery. Postoperative radiation therapy should be considered, especially in cases of with subtotal tumor re
出处
《中国神经肿瘤杂志》
2005年第2期92-98,共7页
Chinese Journal of Neuro-Oncology
