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中国大陆戈谢病综合征:67 例患者的病例系列及文献复习。

Gorham-Stout syndrome in mainland China: a case series of 67 patients and review of the literature.

机构信息

Cardiovascular Key Lab of Zhejiang Province, Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.

出版信息

J Zhejiang Univ Sci B. 2013 Aug;14(8):729-35. doi: 10.1631/jzus.B1200308.

Abstract

OBJECTIVE

Gorham-Stout syndrome (GSS) is a rare disorder of uncertain etiology and unpredictable prognosis. This study aims to present a comprehensive understanding of this rare entity.

METHODS

A literature search in PubMed and three Chinese databases was performed to screen histologically proven GSS cases among Chinese residents in the mainland. We analyzed the patients' clinical characteristics, the value of different treatment modalities and their influence on the clinical outcome.

RESULTS

Sixty-seven cases were finally enrolled. There were 43 men (64.2%) and 24 women (35.8%). The mean age at diagnosis was 28 years (1.5-71 years). The most common clinical symptoms included pain (n=40, 59.7%), functional impairment (n=13, 19.4%), and swelling (n=12, 17.9%). The radiographic presentation of 37 cases (55.2%) was disappearance of a portion of the bone. The others presented as radiolucent foci in the intramedullary or subcortical regions. A total of 42 cases provided data on therapy, these included surgery (n=27, 40.3%), radiation therapy (n=6, 9.0%), surgery combined with radiation therapy (n=2, 3.0%), and medicine therapy (n=7, 10.4%). For 30 of these 42 cases, follow-up data were available: 21 cases had the disorder locally controlled and 9 had a symptom progression. Fortunately, the disease is not fatal in the majority of cases.

CONCLUSIONS

GSS has no specific symptoms and it should be taken into consideration when an unclear massive osteolysis occurs. The efficacies of different treatment modalities are still unpredictable and further research is required to assess the values of different treatments.

摘要

目的

Gorham-Stout 综合征(GSS)是一种病因不明、预后不可预测的罕见疾病。本研究旨在全面了解这一罕见实体。

方法

在 PubMed 和三个中文数据库中进行文献检索,筛选出中国大陆地区经组织学证实的 GSS 病例。我们分析了患者的临床特征、不同治疗方式的价值及其对临床结果的影响。

结果

最终纳入 67 例病例。男 43 例(64.2%),女 24 例(35.8%)。诊断时的平均年龄为 28 岁(1.5-71 岁)。最常见的临床症状包括疼痛(n=40,59.7%)、功能障碍(n=13,19.4%)和肿胀(n=12,17.9%)。37 例(55.2%)的影像学表现为部分骨消失,其余病例表现为骨髓内或皮质下区域的透亮病灶。共有 42 例提供了治疗数据,包括手术(n=27,40.3%)、放疗(n=6,9.0%)、手术联合放疗(n=2,3.0%)和药物治疗(n=7,10.4%)。在这 42 例中有 30 例可获得随访数据:21 例疾病局部控制,9 例症状进展。幸运的是,这种疾病在大多数情况下并不致命。

结论

GSS 无特异性症状,当发生不明原因的大量骨质溶解时应考虑该病。不同治疗方式的疗效仍难以预测,需要进一步研究评估不同治疗方法的价值。

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