[成人髓母细胞瘤不同亚型的病理特征及预后分析]

[Analysis of pathologic characteristics and prognosis in different subtypes of adult medulloblastoma].

作者信息

Zhao Fu, Zhang Jing, Wang Xingchao, Wang Zhenmin, Wang Ying, Qu Peiran, Luo Lin, Liu Pinan

机构信息

Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.

Department of Neurosurgery, Beijing Tiantan Hospital, Affilitated of Capital Medical University, Beijing 100050, China. E-mail:

出版信息

Zhonghua Bing Li Xue Za Zhi. 2014 Mar;43(3):169-72.

PMID:24842015

Abstract

OBJECTIVE

To study the pathologic characteristics and prognosis in different subtypes of adult medulloblastoma (MB).

METHODS

The clinical information, imaging findings and pathologic characteristics of 151 cases of adult medulloblastomas were retrospectively reviewed and analyzed by chi-square test. The survival data were assessed using the Kaplan-Meier method.

RESULTS

Amongst the 151 MB cases studied, there were 73 cases of classic MB, 36 cases of desmoplastic/nodular MB, 39 cases of anaplastic MB and 3 cases of large cell MB. The primary tumors were more frequently located in cerebral hemisphere in desmoplastic/nodular MB than in other subtypes (P=0.000).On the other hand, large cell/anaplastic MB were associated with more frequently local recurrence and distant metastasis (P=0.003). The post-operative overall survival time ranged from 6 to 150 months, with median survival being (103.3±5.7) months (95%CI, 92.52 to 115.09). The median survival of classic MB, desmoplastic/nodular MB and large cell/anaplastic MB was (110.7±7.8) months, (125.5±7.6) months and (57.6±7.6) months, respectively. The differences were statistically significant (P=0.000).

CONCLUSIONS

The three variants of MB show different biologic behavior. Large cell/anaplastic MB represents an independent poor prognostic indicator in adults.

摘要

目的

研究成人髓母细胞瘤（MB）不同亚型的病理特征及预后。

方法

回顾性分析151例成人髓母细胞瘤的临床资料、影像学表现及病理特征，并进行卡方检验。采用Kaplan-Meier法评估生存数据。

结果

在研究的151例MB病例中，经典型MB 73例，促纤维增生/结节型MB 36例，间变型MB 39例，大细胞型MB 3例。促纤维增生/结节型MB的原发肿瘤较其他亚型更常位于脑半球（P = 0.000）。另一方面，大细胞/间变型MB局部复发和远处转移更为常见（P = 0.003）。术后总生存时间为6至150个月，中位生存时间为（103.3±5.7）个月（95%CI，92.52至115.09）。经典型MB、促纤维增生/结节型MB和大细胞/间变型MB的中位生存时间分别为（110.7±7.8）个月、（125.5±7.6）个月和（57.6±7.6）个月。差异具有统计学意义（P = 0.000）。