[两个年龄组儿童（0至10岁和10至18岁）颅外恶性生殖细胞肿瘤的特征。多中心经验]

[Characteristics of extracranial malignant germ cell tumours in two age groups of children (0-10 and 10-18 years). Multicentre experiences].

作者信息

Drozyńska Elzbieta, Połczyńska Katarzyna, Popadiuk Stefan, Niedzwiecki Maciej, Wiśniewski Jakub, Balcerska Anna, Izycka-Swieszewska Ewa, Bilska Katarzyna, Balwierz Walentyna, Chełmecka Lilianna, Chybicka Alicja, Dudeńko Izabella, Karolczyk Grazyna, Kowalczyk Jerzy, Krawczuk-Rybak Maryna, Kurylak Andrzej, Leszczyńska Elzbieta, Matysiak Michał, Młynarski Wojciech, Pobudejska Aneta, Sobol Grazyna, Sońta-Jakimczyk Danuta, Szajdak Katarzyna, Tredowska-Skoczeń Dorota, Szmyd Krzysztof, Trelińska Joanna, Urasiński Tomasz, Wachowiak Jacek, Wieczorek Maria, Wiśniewska-Slusarz Hanna, Woźniak Sebastian, Woźniak Wojciech, Wysocki Mariusz

机构信息

Praca wieloośrodkowa z 15 ośrodków Onkologii Dzieciqcej w Polsce pod kierunkiem Kliniki Pediatrii, Hematologii, Chemioterapii i Endokrynologii GUMed w Gdarisku.

出版信息

Med Wieku Rozwoj. 2011 Jan-Mar;15(1):16-24.

PMID:21786508

Abstract

UNLABELLED

In order to assess if any differences exist in children germ cell tumours depending on age, we compared some features of germ cell tumours in two age groups:younger than 10 and between 11 and 18 years.

MATERIAL AND METHODS

Data of 146 patients with germ cell tumours treated in 15 Polish paediatric oncology departments between 1995 and 2005 were evaluated. They were divided into two groups: 76 children 0-10 years old (group I) and 70 patients 11-18 years old (group II). Tumour morphology, sex of patients, primary tumour and metastases localization, disease stage, biochemical markers, treatment response, disease relapse and long survival were analyzed. Every patient was treated according to the TGM 95 protocol.

RESULTS

In group 1, 67 tumours were assessed histologically. 64%t tumours had homogenous structure with yolk sac tumour in predominance and 36% were mixed. Yolk sac tumour (YST) or teratoma as components of mixed tumours were the most commonly found. In older group 64 tumours were examined, 41% were homogenous, and seminoma/dysgerminoma predominated. In 59% mixed tumours the most common components were YST embryonal carcinoma and teratoma. The most common primary site in group I was the sacrococcygeal region while in group II - the gonads. Disseminated disease was recognized mostly in older children. Among two evaluated serum markers, AFP was increased mostly in younger patients (76% vs 44%), and 3HCG in older group (40% vs 9%). Treatment response was comparable in both groups. Two relapses were observed in each group. Poor outcome was noted in 17/140 analyzed patients: 9 (12%) in group I and 8 (11%) in group II. In 12 of patients with poor outcome the cause of death was progression and in 5 of them - treatment complications.

CONCLUSIONS

Germ cell tumours in younger and older children differ in histology, primary localization and serum level of biochemical markers. 2. In older patients germ cell tumours are recognized more frequently in advanced clinical stages. 3. Treatment response was comparable in both groups. 4. There is a need to analyze the intensity of chemotherapy to precise the adequate risk groups according to primary treatment response.

摘要

未标注

为了评估儿童生殖细胞肿瘤是否因年龄不同而存在差异，我们比较了两个年龄组生殖细胞肿瘤的一些特征：10岁以下和11至18岁。

材料与方法

评估了1995年至2005年间在15个波兰儿科肿瘤科室接受治疗的146例生殖细胞肿瘤患者的数据。他们被分为两组：76例0至10岁的儿童（第一组）和70例11至18岁的患者（第二组）。分析了肿瘤形态、患者性别、原发肿瘤和转移灶的定位、疾病分期、生化标志物、治疗反应、疾病复发和长期生存情况。每位患者均按照TGM 95方案进行治疗。

结果

在第一组中，对67例肿瘤进行了组织学评估。64%的肿瘤具有均匀结构，以卵黄囊瘤为主，36%为混合型。卵黄囊瘤（YST）或畸胎瘤作为混合性肿瘤的组成部分最为常见。在年龄较大的组中，检查了64例肿瘤，41%为均匀型，精原细胞瘤/无性细胞瘤占主导。在59%的混合性肿瘤中，最常见的组成部分是YST、胚胎性癌和畸胎瘤。第一组中最常见的原发部位是骶尾部，而在第二组中是性腺。播散性疾病大多在年龄较大的儿童中被发现。在两项评估的血清标志物中，甲胎蛋白（AFP）大多在较年轻患者中升高（76%对44%），而β人绒毛膜促性腺激素（β-HCG）在年龄较大组中升高（40%对9%）。两组的治疗反应相当。每组均观察到2例复发。在140例分析患者中有17例预后不良：第一组9例（12%），第二组8例（11%）。在12例预后不良的患者中，死亡原因是病情进展，其中5例是治疗并发症。