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松果体区肿瘤的临床研究:132例患者的经验

[Clinical study of pineal region tumors: experience with 132 patients].

作者信息

Qiu Bing-Hui, Fang Lu-Xiong, Zhang Xi-An, Qi Song-Tao

机构信息

Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2010 Jun;32(6):441-3.

Abstract

OBJECTIVE

To review the clinical manifestations, imaging, tumor markers, treatment methods, pathology results and clinical curative effects of pineal region tumors and to evaluate the characteristics and intervention strategies for those tumors.

METHODS

The clinicopathological data of 132 patients with pineal region tumor treated in our department between January 2000 and May 2008 were retrospectively studied.

RESULTS

A moderate predominance in males was presented. The clinical manifestations of the disease included increased intracranial pressure and ocular movement impairment. There were some features but no regularity and specific appearance on imaging including CT and MRI. 88.6% of patients associated with hydrocephalus. A high serum level of alpha-fetoprotein (AFP) was presented in 14 cases and high HCG in 9 cases. Eighteen cases received direct radiation therapy and 7 had radiotherapy post biopsy. 107 cases were treated surgically and 63 cases received postoperative adjuvant treatment. 114 cases had pathology results including 56 germ cell tumors. The patients were followed up for 12 approximately 132 months. Recurrence developed in 23 cases and 12 cases died. The 5-year survival rate was 89.3%.

CONCLUSION

Pineal region tumors are often associated with hydrocephalus and this makes preoperative diagnosis difficult. Imaging examination may help diagnosis but less specific. Germ cell tumors may diagnosed by some tumor markers. Radiation therapy is the choice of treatment for pure germinomas. Other types of pineal region tumors should receive surgical treatment. Postoperative adjuvant treatment based on pathology can provide a good prognosis in pineal region tumor.

摘要

目的

回顾松果体区肿瘤的临床表现、影像学表现、肿瘤标志物、治疗方法、病理结果及临床疗效,评估这些肿瘤的特点及干预策略。

方法

回顾性研究2000年1月至2008年5月在我科治疗的132例松果体区肿瘤患者的临床病理资料。

结果

男性略占优势。该病的临床表现包括颅内压升高和眼球运动障碍。在包括CT和MRI在内的影像学检查中有一些特征,但无规律及特异性表现。88.6%的患者合并脑积水。14例患者血清甲胎蛋白(AFP)水平升高,9例患者人绒毛膜促性腺激素(HCG)水平升高。18例患者接受直接放射治疗,7例在活检后接受放射治疗。107例患者接受手术治疗,63例患者接受术后辅助治疗。114例患者有病理结果,其中56例为生殖细胞肿瘤。患者随访约12至132个月。23例患者复发,12例死亡。5年生存率为89.3%。

结论

松果体区肿瘤常合并脑积水,这使得术前诊断困难。影像学检查有助于诊断,但特异性较低。生殖细胞肿瘤可通过一些肿瘤标志物诊断。放射治疗是纯生殖细胞瘤的治疗选择。其他类型的松果体区肿瘤应接受手术治疗。基于病理的术后辅助治疗可使松果体区肿瘤获得良好预后。

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