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神经细胞瘤:一篇综述

Neurocytoma: a comprehensive review.

作者信息

Sharma Mehar Chand, Deb Prabal, Sharma Suash, Sarkar Chitra

机构信息

Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

出版信息

Neurosurg Rev. 2006 Oct;29(4):270-85; discussion 285. doi: 10.1007/s10143-006-0030-z. Epub 2006 Aug 29.

Abstract

Central neurocytomas (CN) are uncommon tumors of the central nervous system, most descriptions of which available in the literature are in the form of isolated case reports and small series. Owing to this rare incidence, diagnosis and management of this neoplasm remain controversial. Usually, these tumors affect lateral ventricles of young adults and display characteristic neuroimaging and histomorphologic findings. Neurocytomas often mimic oligodendrogliomas when confirmation of diagnosis rests on immunohistochemistry, ultrastructure, and genetic studies. Extraventricular neurocytomas, situated entirely within the brain parenchyma and spinal cord, have also been reported. Typically, CN are associated with a favorable outcome although cases with more aggressive clinical course with recurrences are not unknown. MIB-1 labeling index (LI) of >2% often heralds poor prognosis and tumour recurrence. Safe maximal resection is presently considered the ideal therapeutic option, with best long-term prognosis in terms of local control and survival. The role of adjuvant radiotherapy apparently seems to benefit patients with incomplete resection and in atypical neurocytoma. Utility of other therapeutic regimen, however, remains shrouded in controversy. Epidemiology, histogenesis, clinical profile, histology, neuroimaging and therapeutic modalities of neurocytomas have been comprehensively reviewed, with special emphasis on CN and extraventricular neurocytomas and their atypical counterparts.

摘要

中枢神经细胞瘤(CN)是中枢神经系统的罕见肿瘤,文献中对其的大多数描述都是以孤立病例报告和小系列研究的形式呈现。由于其发病率罕见,这种肿瘤的诊断和治疗仍存在争议。通常,这些肿瘤累及年轻成年人的侧脑室,并表现出特征性的神经影像学和组织形态学表现。当诊断依靠免疫组织化学、超微结构和基因研究来证实时,神经细胞瘤常与少突胶质细胞瘤相似。也有报道称存在完全位于脑实质和脊髓内的脑室外神经细胞瘤。典型情况下,中枢神经细胞瘤的预后良好,尽管也有临床病程更具侵袭性且复发的病例。MIB - 1标记指数(LI)>2%往往预示着预后不良和肿瘤复发。目前,安全最大化切除被认为是理想的治疗选择,在局部控制和生存方面具有最佳的长期预后。辅助放疗的作用显然似乎使不完全切除的患者和非典型神经细胞瘤患者受益。然而,其他治疗方案的效用仍存在争议。本文对神经细胞瘤的流行病学、组织发生学、临床特征、组织学、神经影像学和治疗方式进行了全面综述,特别强调了中枢神经细胞瘤和脑室外神经细胞瘤及其非典型对应物。

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