摘要
目的：探讨各临床因素、治疗对原始神经外胚层瘤（primitive neuroecto dermal tumor，PNET）预后的影响。方法：回顾性分析2004—12—06—2012—10—25苏州大学附属第一医院收治的46例PNET患者临床资料，其中男28例，女18例，男女比例为1．56：1；年龄6～84岁，中位年龄37岁；肿瘤原发部位位于非中线部位为21例，位于中线部位或盆腔为25例；46例患者中Ⅰ～Ⅱ期患者14例（30．4％），Ⅲ期14例（30．4％），Ⅳ期18例（39．1％）。29例患者初诊时LDH值〈225U／L，17例≥225U／L。12例行根治术＋化疗／放疗，16例行单纯根治术，4例行姑息术，14例放疗／化疗。采用Ka—plan-Meier法进行单因素生存分析，Log—rank法检验差异显著性，Cox回归模型进行多因素分析，偏相关进行相关性分析。结果：全组中位生存期为10个月（2～50个月），1、3年生存率分别为48．0％和11．0％。单因素分析显示，肿瘤原发部位、分期、初诊时LDH值和治疗方式可以影响全组患者的总生存期；多因素分析显示，原发部位、分期、初诊时LDH值和治疗方式是影响患者生存的独立预后因素。偏相关分析显示，Ki-67表达强度与生存时间呈负相关。结论：原发部位在盆腔或中线位、分期晓和初诊时LDH值≥225U／L是PNET患者预后不良的主要因素，采用综合治疗可延长PNET患者的生存时间。
OBJECTIVE：To investigate the effects of clinical factors and treatment modality on primitive neuroecto- dermal tumor（PNET） prognosis. METHODS： From December 6th, 2004 to October 25th, 2012, forty six patients diag- nosed with PNET were investigated. Among these patients,28 cases were male and 18 were female,with the ratio of male to female 1.56 ： 1. The median age was 37 years,ranging from 6 to 84 years. Original sites of 21 cases were located in the non-midline,while 25 in the midline or pelvic. There were 14 cases（30.4%） with stageⅠand Ⅱ , and the percentage of stage Ⅲ and Ⅳ were 30.40/oo and 39.1% ,respectively. The values of LDH were less than 225 U/L in 29 cases when they were diagnosed,while 17 cases no less than 225 U/L. Twelve patients received comprehensive treatment and 16 cases un- derwent radical surgery, while the rest received palliative surgery or radiotherapy or chemotherapy. The Kaplan-Meier method and Cox regression were used in survival analysis, and the Log-rank method was used to test the significance of difference. The partial correlation analysis was used to analyze bivariate correlation. RESULTS.. The overall median surviv- al time was 10 months,ranging from 2 to 50 months. The survival rates of 1 year and 3 years were 48.0% and 11.0% re- spectively. The univariate analysis showed that the original site, the stage,the initial value of LDH, and the treatment mo- dality affected the survival of PNET patients. The multivariate analysis prompted the original site,the stage, the initial val- ue of LDH and the treatment modality were independent prognostic factors. The partial correlation analysis showed that the survival time was negatively correlated to the expression of Ki-67. CONCLUSION： The original site in the pelvic, the stage Ⅲ or Ⅳ ,and the initial value of LDH equal to or large than 225 U/L are major poor prognosis factors of PNET pa- tients. The combined treatment can prolong survival time.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2014年第3期228-231,共4页
Chinese Journal of Cancer Prevention and Treatment
