摘要
目的:分析儿童颅外生殖细胞肿瘤的临床特点、治疗及生存情况。方法:回顾性分析2013年9月—2021年4月河南省儿童医院血液肿瘤科诊治的49例颅外生殖细胞肿瘤患者的临床资料,以Kaplan-Meier法进行生存分析,以COX回归进行预后影响因素分析。结果:49例患者中男性23例,女性26例,中位年龄2岁2月;随访至2021年4月,中位随访时间3.8年,全组生存率为85.7%,对影响预后的因素进行分析,结果显示性别、肿瘤发生部位、病理类型、分期均是影响预后的因素,病初是否合并甲胎蛋白(AFP)或β-人绒毛膜促性腺激素(β-HCG)的升高不是影响预后的危险因素,进行多因素分析结果显示,病理类型及分期是影响预后的独立危险因素,病理类型为卵黄囊瘤和未成熟畸胎瘤患儿预后较好(生存率分别为90.6%和90.0%),而混合性生殖细胞肿瘤患儿预后较差,Ⅰ~Ⅱ期患儿生存率较高(100.0%),Ⅲ期患儿生存率为93.3%,Ⅳ期患儿预后较差。结论:手术联合含铂类药物的化疗使生殖细胞肿瘤患者获得很好的生存,尽早明确生殖细胞肿瘤患儿的病理类型、分期,采用合适的综合治疗,可以提高治愈率、延长生存期。
Objective:To analyze the clinical features,treatment and survival of germ cell tumors in children.Methods:Data of 49 patients with germinal cell tumor treated in hematology and Oncology Department of Henan Children’s Hospital from September 2013 to April 2021 were collected.Kaplan-Meier method was used for survival analysis,and COX regression was used for prognostic factors analysis.Results:Among the 49 patients,there were 23 males and 26 females,with a median age of 2 years and 2 months.The median follow-up time was 3.8 years.The survival rate of the whole group was 85.7%.Gender,tumor site,pathological type and stage were all factors affecting the prognosis.The increase of AFP orβ-HCG at the beginning of the disease was not a risk factor affecting the prognosis.The results of multivariate analysis showed that pathological type and stage were independent risk factors affecting the prognosis.The prognosis of children with pathological types of yolk cystoma and immature teratoma was higher(survival rate:90.6%and 90.0%,respectively),while the prognosis of children with mixed germ cell tumor was worse.The survival rate of children with stageⅠ-Ⅱwas higher(100%),the survival rate of stageⅢchildren was 93.3%,while the prognosis of stageⅣchildren was poor.Conclusion:Surgery combined with platinum-containing chemotherapy can achieve good survival for patients with germ cell tumor.Early identification of pathological types and stages of children with germ cell tumor and appropriate comprehensive treatment can improve the cure rate and prolong survival.
作者
翟素花
郭丽丽
李彦格
刘炜
Zhai Suhua;Guo Lili;Li Yange(Department of Hematology and Oncology,Children’s Hospital Affiliated to Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Henan,Zhengzhou 450000,China)
出处
《黑龙江医学》
2024年第2期168-171,共4页
Heilongjiang Medical Journal
关键词
生殖细胞肿瘤
儿童
化疗
生存率
Germ cell tumors
Children
Chemotherapy
Survival rate
