摘要
目的 分析儿童后颅窝髓母细胞瘤(MB)的组织病理分型与预后的相关性。方法 回顾性分析2000-01—2010-01郑州儿童医院收治的111例儿童后颅窝髓母细胞瘤患者的组织病理学检查结果、预后结局及其他临床资料,采用Kaplan-Meier单因素分析对各病理亚型预后进行比较。结果 111例患者中男72例,女39例,年龄1~16岁;病理学分型中经典型髓母细胞瘤80例(72.0%),促纤维增生/结节型20例(18.0%),广泛结节型5例(4.5%),间变型4例(3.6%),大细胞型2例(1.8%);显微手术全切除90例,次全切除15例,部分切除6例;术后化疗53例,放疗12例,放疗联合化疗14例;随访时间6~150个月,至随访期结束时,存活59例,死亡52例。统计显示,手术肿瘤全切除5a生存率(61.1%)最高,部分切除5a生存率(0)最低;CMB所占比例(72%)最高,DNMB/MBEN5a存活率(72.0%)最高,LC/AMB生存时间(13.6±7.48)个月最短,5a存活率(0)最低。结论 儿童后颅窝髓母细胞瘤不同组织病理学分型及手术切除程度是影响患者预后的重要因素,大细胞/间变型预后差,手术全切肿瘤可以延长生存时间和提高5a生存率。
Objective To investigate the correlation between histopathology type and prognosis of posterior fossa medulloblastoma (MB) in children. Methods Retrospective analysis was conducted to analyze the histopathology results,prognosis and other clinical data of 111 children with posterior fossa medulloblastoma between January 2000 and January 2010 in Zhengzhou Children's Hospital,and Kaplan Meier single factor analysis was used to compare the prognosis of each pathological type. Results 111 cases of children included 72 males and 39 females,aged 1 to 16 years old;The histopathology type of CMB,DNMB,MBEN,AMB,and LCMB was observed in 80 cases(72.0%),20 cases(18.0%),5 cases(4.5%),4 cases(3.6%) and 2 cases(1.8%),respectively.Total resection had been made in 90 cases by microsurgery,subtotal resection in 15 cases,and partial resection in 6 cases.After surgery,53 cases received chemotherapy,12 cases received radiotherapy,and 14 cases received radiotherapy and chemotherapy.The follow up time was 6 150 months,and 59 cases survived and 52 cases died at the end of the follow up.The statistical results showed that,the 5 year survival rate (61.1%) of the total resection was the highest,and the 5 year survival rate (0) of the partial resection was the lowest;the proportion of CMB (72%) was the highest,and the 5 year survival rate (72.0%) of DNMB/MBEN was highest,and the mean survival time (13.6±7.48) months of LC/AMB was the shortest,and the 5 year survival rate (0) of LC/AMB was the lowest. Conclusion The different histopathology types and surgical resection degree of posterior fossa medulloblastoma in children,was important factor affecting the prognosis of patients,the difference was statistically significant ( P <0.05),and the prognosis of LC/AMB is poor,and the total resection can prolong the survival time and improve the 5 year survival rate.
作者
李涛
周兴
海莉丽
吴晓东
齐林
LI Tao;ZHOU Xing;HAI Lili;WU Xiaodong;QI Lin(Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital/Zhengzhou Children's Hospital,Zhengzhou 450000,China;Zhengzhou First People's Hospital,Zhengzhou 450000,China)
出处
《中国实用神经疾病杂志》
2019年第11期1173-1178,共6页
Chinese Journal of Practical Nervous Diseases
基金
河南省医学科技攻关计划项目(编号:2018020671)
关键词
髓母细胞瘤
后颅窝
组织病理学分型
预后
儿童
Medulloblastoma
Posterior fossa
Histopathology type
Prognosis
Children
