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[外周神经母细胞瘤的临床病理特征]

[Clinicopathologic features of peripheral neuroblastic tumors].

作者信息

Yang Bao-feng, Fu Li-bing, He Le-jian

机构信息

Department of Pathology, Capital Medical University, Beijing, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2013 May;42(5):305-10. doi: 10.3760/cma.j.issn.0529-5807.2013.05.004.

Abstract

OBJECTIVE

To study the clinicopathologic characteristics of peripheral neuroblastic tumors and to evaluate the prognostic significance of these features.

METHODS

The clinical and pathologic findings were retrospectively reviewed in 121 cases of peripheral neuroblastic tumor. The clinical outcomes of patients were evaluated. The three-year event-free survival rate was analyzed, with respect to age of patients, Evan's staging, International Neuroblastoma Pathology Classification and mitosis-karyorrhexis index.

RESULTS

The median age at diagnosis was 2.7 years; and 96 cases (79.3%) occurred in patients younger than 5 years old. The number of cases in Evan's staging I, II, III, IV and IVs was 24, 39, 24, 29 and 5, respectively. There were 82 cases of neuroblastoma (NB) (including 2 cases of undifferentiated NB, 52 cases of poorly differentiated NB and 28 cases of differentiating NB), 9 cases of ganglioneuroblastoma, intermixed type (GNBi), 19 cases of ganglioneuroma, maturing type (GN) and 11 cases of ganglioneuroblastoma, nodular type (GNBn). Forty-nine cases were in the favorable histology subgroup and 72 cases in the unfavorable histology subgroup. The overall three-year event-free survival rate of the 121 cases was 73.0% ± 4.3%. The three-year event-free survival rates were associated with age (P = 0.002), Evan's staging (P = 0.000), histologic category (P = 0.000), mitosis-karyorrhexis index (P = 0.043), prognostic subgroup (P = 0.000).

CONCLUSIONS

Most of the peripheral neuroblastic tumors occur in the children younger than 5 years old. It is composed of NB, GNBi, GN and GNBn. The three-year event-free survival rate is approximately 70%. Significant prognostic parameters include age of patients, Evan's staging, International Neuroblastoma Pathology Classification and mitosis-karyorrhexis index.

摘要

目的

研究外周神经母细胞瘤的临床病理特征,并评估这些特征的预后意义。

方法

回顾性分析121例外周神经母细胞瘤的临床和病理资料。评估患者的临床结局。分析患者年龄、伊文斯分期、国际神经母细胞瘤病理分类及核分裂-核溶解指数对三年无事件生存率的影响。

结果

诊断时的中位年龄为2.7岁;96例(79.3%)发生于5岁以下患者。伊文斯分期I、II、III、IV和IVs期的病例数分别为24、39、24、29和5例。其中神经母细胞瘤(NB)82例(包括未分化NB 2例、低分化NB 52例和分化型NB 28例),节细胞神经母细胞瘤混合型(GNBi)9例,节细胞神经瘤成熟型(GN)19例,节细胞神经母细胞瘤结节型(GNBn)11例。49例属于预后良好组织学亚组,72例属于预后不良组织学亚组。121例患者的总体三年无事件生存率为73.0%±4.3%。三年无事件生存率与年龄(P = 0.002)、伊文斯分期(P = 0.000)、组织学类型(P = 0.000)、核分裂-核溶解指数(P = 0.043)、预后亚组(P = 0.000)相关。

结论

大多数外周神经母细胞瘤发生于5岁以下儿童。它由NB、GNBi、GN和GNBn组成。三年无事件生存率约为70%。重要的预后参数包括患者年龄、伊文斯分期、国际神经母细胞瘤病理分类及核分裂-核溶解指数。

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