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[原发性心脏肿瘤的临床发病率]

[Clinical incidence of primary cardiac tumors].

作者信息

Endo A, Ohtahara A, Kinugawa T, Nawada T, Fujimoto Y, Mashiba H, Shigemasa C

机构信息

First Department of Internal Medicine, Faculty of Medicine, Tottori University, Yonago.

出版信息

J Cardiol. 1996 Oct;28(4):227-34.

PMID:8934339
Abstract

Recently, clinical diagnostic methods for heart disease, especially echocardiography, have remarkably progressed and the incidence of cardiac tumors increased. This study investigated the characteristics of tumors in 115 patients with primary cardiac tumor, diagnosed histologically in 1993-1994, in collaboration with 126 university hospitals in Japan. Histological diagnosis, location, initial clinical manifestations and prognosis of cardiac tumors are reported. Of the 115 patients, 98 (85%) had primary benign tumor. Myxoma was the most common histological group (91 cases). Primary malignant cardiac tumors occurred in 17 patients (15%) of which rhabdomyosarcoma was the most frequent (5 cases). Sixty percent of patients with myxoma were female, a similar ratio to the proportion of female patients with other primary cardiac tumors. Most patients with myxoma had the tumor in the left side of the heart [76 cases (84%) in left side, 12 (13%) in right side, 3 (3%) in both sides]. In contrast, the primary malignant cardiac tumors occurred more in the right side of the heart rather than in the left side (eight in right side, six in left side). Embolization was the characteristic initial clinical manifestation for myxoma. There were no patients with initial manifestation of embolization in the other histological groups. Reflecting the recent progress and spread of clinical diagnostic methods, 17% of all patients were discovered asymptomatically. All patients with myxoma who were asymptomatic underwent operation, and there were no surgical deaths. In contrast, only one patient with primary malignant cardiac tumor could survive longer than a year. In conclusion, the progress and the spread of cardiovascular imaging has contributed to the early diagnosis of primary cardiac tumors. These data demonstrate new clinical and pathological characteristics of primary cardiac tumors seen in recent cardiologic practice in Japan.

摘要

近年来,心脏病的临床诊断方法,尤其是超声心动图,取得了显著进展,心脏肿瘤的发病率也有所上升。本研究与日本126家大学医院合作,调查了1993年至1994年间经组织学诊断的115例原发性心脏肿瘤患者的肿瘤特征。报告了心脏肿瘤的组织学诊断、位置、初始临床表现和预后。115例患者中,98例(85%)患有原发性良性肿瘤。黏液瘤是最常见的组织学类型(91例)。原发性恶性心脏肿瘤发生在17例患者(15%)中,其中横纹肌肉瘤最为常见(5例)。黏液瘤患者中60%为女性,这一比例与其他原发性心脏肿瘤女性患者的比例相似。大多数黏液瘤患者的肿瘤位于心脏左侧[左侧76例(84%),右侧12例(13%),双侧3例(3%)]。相比之下,原发性恶性心脏肿瘤更多发生在心脏右侧而非左侧(右侧8例,左侧6例)。栓塞是黏液瘤特有的初始临床表现。其他组织学类型中没有患者以栓塞为初始表现。反映出临床诊断方法的最新进展和普及,所有患者中有17%是无症状发现的。所有无症状的黏液瘤患者均接受了手术,且无手术死亡病例。相比之下,只有1例原发性恶性心脏肿瘤患者存活时间超过1年。总之,心血管成像的进展和普及有助于原发性心脏肿瘤的早期诊断。这些数据展示了日本近期心脏病学实践中所见原发性心脏肿瘤的新的临床和病理特征。

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