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中枢神经细胞瘤的临床谱从良性到软脑膜播散性疾病:一个机构的33例患者手术系列报道

The clinical spectrum of central neurocytomas ranges from benign to leptomeningeal disseminating disease: a single institutional surgical series of 33 patients.

作者信息

Yaşar A Harun, Erşen-Danyeli Ayça, Bozkurt Baran, Usseli M İmre, Güdük Mustafa, Özduman Koray, Pamir M Necmettin

机构信息

Department of Neurosurgery, School of Medicine, Acıbadem University, Istanbul, Turkiye.

Department of Pathology, School of Medicine, Acıbadem University, Istanbul, Turkiye.

出版信息

Front Surg. 2025 Jul 18;12:1534566. doi: 10.3389/fsurg.2025.1534566. eCollection 2025.

Abstract

BACKGROUND

Central neurocytomas (CN) are rare neuroepithelial neoplasms primarily found in the lateral ventricles. While generally considered benign, their clinical behavior varies, with some cases displaying atypical features associated with increased recurrence risk.

MATERIAL AND METHODS

This is a retrospective analysis of 33 adult CN patients that were operated and followed over a 25-year period by a single surgeon. Demographic (age, gender), anatomical (localization), histopathological (atypical histology, Ki67 index, p75NTR expression), extent of resection (GTR vs. STR), adjuvant treatments (radiotherapy and radiosurgery) were analyzed as potential prognostic factors.

RESULTS

Gross total resection (GTR) was associated with favorable outcomes, with adjuvant radiotherapy effective after subtotal resection (STR). Notably, a subset of aCN cases exhibited p75NTR immunopositivity, suggesting its potential as a prognostic marker for aggressive behavior. Leptomeningeal dissemination was rare but observed in one case.

CONCLUSION

CN cases demonstrate clinical heterogeneity, emphasizing the importance of tailored management. Close follow-up is crucial, particularly in atypical cases, to optimize patient outcomes. GTR remains the goal in surgery, while p75NTR expression may serve as a prognostic indicator but further research is needed to validate p75NTR as a prognostic factor in CN.

摘要

背景

中枢神经细胞瘤(CN)是一种罕见的神经上皮肿瘤,主要发生于侧脑室。虽然通常被认为是良性的,但其临床行为存在差异,部分病例表现出与复发风险增加相关的非典型特征。

材料与方法

这是一项对33例成年CN患者的回顾性分析,这些患者在25年期间由同一外科医生进行手术并随访。分析了人口统计学(年龄、性别)、解剖学(定位)、组织病理学(非典型组织学、Ki67指数、p75NTR表达)、切除范围(全切术与次全切术)、辅助治疗(放疗和立体定向放射外科治疗)等潜在预后因素。

结果

全切术(GTR)与良好的预后相关,次全切术(STR)后辅助放疗有效。值得注意的是,一部分非典型CN病例表现出p75NTR免疫阳性,提示其可能作为侵袭性行为的预后标志物。软脑膜播散罕见,但有1例观察到。

结论

CN病例表现出临床异质性,强调了个体化管理的重要性。密切随访至关重要,尤其是在非典型病例中,以优化患者预后。手术的目标仍然是全切术,而p75NTR表达可能作为一种预后指标,但需要进一步研究以验证p75NTR作为CN预后因素的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/458c/12313656/c6fe1f6946e2/fsurg-12-1534566-g001.jpg

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