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婴儿神经母细胞瘤的临床特征及治疗结果总结。

Clinical characteristics of infant neuroblastoma and a summary of treatment outcome.

作者信息

Zhang Yi, Huang Dongsheng, Zhang Weiling, Tang Suoqin, Han Tao, Zhu Xia, Liu Aiping, Zhi Tian

机构信息

Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, P.R. China; Department of Pediatrics, Chinese People's Liberation Army General Hospital, Medical School of Chinese People's Liberation Army, Beijing 100039, P.R. China.

Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, P.R. China.

出版信息

Oncol Lett. 2016 Dec;12(6):5356-5362. doi: 10.3892/ol.2016.5353. Epub 2016 Nov 4.

Abstract

Neuroblastoma (NB) is the most common malignant solid tumor in the peripheral nervous system in infants and young children, with a high degree of malignancy. The clinical characteristics and prognosis of NB in infants are unique. The present study retrospectively analyzed the prognosis of infant NB cases that underwent different treatments. In total, 16 infant NB cases (10 male and 6 female) who were treated between February 2007 and August 2013 in Beijing Tongren Hospital (Beijing, China), were enrolled in the study. They were diagnosed by pathology, medical imaging and serology methods. These 16 patients were subjected to comprehensive treatment, including chemotherapy, surgery, autologous peripheral blood stem cell transplantation (APBSCT) and radiation therapy. The age distribution and clinical stages were: 5 cases (31.25%) at ≤3 months (4 cases at stage 4s and 1 case at stage 4); 2 cases (12.5%) at 3-6 months (both at stage 4s); and 9 cases (56.25%) at 6-12 months (2 cases at stage 4s, 6 cases at stage 4 and 1 case at stage 3). Subsequent to treatment, nicotinic acid esterase (NSE) levels in the patient's serum significantly decreased. The NSE levels in 12 cases (75%) dropped to the reference value (0-15.2 ng/dl). All the NB infants at stages 4s and 3 were treated by surgery and chemotherapy (100%; 9/9). The 5 NB infants at stage 4 were treated by chemotherapy and surgery. For the 2 NB infants who experienced recurrence or whose condition was partially relieved after conventional therapy, APBSCT therapy was applied. At the last follow-up in September 2014, 13 cases (81.25%) presented with a complete response, 2 cases (12.50%) with a partial response and 1 case (6.25%) with recurrence after transplantation (progressive disease). In conclusion, infant NB cases are sensitive to chemotherapy, particularly the cases at stage 4s, which occur with a higher incidence, but with a better clinical response and prognosis after treatment.

摘要

神经母细胞瘤(NB)是婴幼儿外周神经系统最常见的恶性实体瘤,恶性程度高。婴儿NB的临床特征和预后具有独特性。本研究回顾性分析了接受不同治疗的婴儿NB病例的预后。共有16例婴儿NB病例(男10例,女6例)纳入研究,这些病例于2007年2月至2013年8月在北京同仁医院(中国北京)接受治疗。通过病理、医学影像和血清学方法进行诊断。这16例患者接受了综合治疗,包括化疗、手术、自体外周血干细胞移植(APBSCT)和放射治疗。年龄分布及临床分期为:≤3个月的5例(31.25%)(4例为4s期,1例为4期);3 - 6个月的2例(12.5%)(均为4s期);6 - 12个月的9例(56.25%)(2例为4s期,6例为4期,1例为3期)。治疗后,患者血清中的烟酸酯酶(NSE)水平显著下降。12例(75%)患者的NSE水平降至参考值(0 - 15.2 ng/dl)。所有4s期和3期的NB婴儿均接受了手术和化疗(100%;9/9)。5例4期NB婴儿接受了化疗和手术。对于2例常规治疗后复发或病情部分缓解的NB婴儿,采用了APBSCT治疗。在2014年9月的最后一次随访中,13例(81.25%)完全缓解,2例(12.50%)部分缓解,1例(6.25%)移植后复发(疾病进展)。总之,婴儿NB病例对化疗敏感,尤其是4s期病例,其发病率较高,但治疗后临床反应较好,预后良好。

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