摘要
目的分析不同年龄段小脑囊实性肿瘤的病理类型、手术切除程度和治疗效果等。方法影像学表现为小脑囊实性肿瘤病人68例,按照年龄分为青少年组36例(年龄<18岁)和成年组32例(年龄≥18岁)。根据肿瘤大小和部位选择枕下正中或旁正中入路肿瘤切除术。分析统计两组病人病理类型、手术全切率、并发症发生率和治愈率。结果青少年组以毛细胞星形细胞瘤多见(20例,55.5%),成年组主要是血管母细胞瘤(13例,40.6%),两组比较差异有统计学意义(P<0.05)。成年组髓母细胞瘤手术全切率(22.2%)及治疗有效率(33.3%)均低于青少年组(50.0%和44.4%)。两组毛细胞星形细胞瘤及血管母细胞瘤手术全切率均为100%,青少年组毛细胞星形细胞瘤治愈率94.7%,而成年组血管母细胞瘤治愈率为81.8%。两组术后并发症发生率无显著差别。结论小脑囊实性肿瘤在青少年病人中以毛细胞星形细胞瘤多见,成年病人中以血管母细胞瘤为多;两组毛细胞星形细胞瘤及血管母细胞瘤手术全切率高,术后疗效好,而髓母细胞瘤病人手术全切率低,预后较差。
Objective To analyze the clinical features,the extent of tumor removal and the prognosis of patients of cerebellum solid-cystic tumors in different age groups.Methods The clinical datas of 68 cases of cerebellum solid-cystic tumors with MRI was retrospectively analyzed.Patients younger than 18-year-old or 18-year-old were grouped into the adolescent group and patients older than 18-year-old were grouped into the adult group.Results The predominant pathological type of tumors was pilocytic astrocytoma(PA)(n=20,55.5%)in adolescent group,and hemangioblastoma(HB)(n=13,40.6%)in adult group(χ~2=28.69,P<0.01).Additionally,tumor resection rate and curative rate of medulloblastoma(22.2% and 33.3%)in adult group was lower than those in adolescent group(50.5% and 44.4%).The 100% of total tumor resection rate of PA and HB was demonstrated in adolescent group and adult group,however,tumor curative rate of PA in adolescent group was 94.7% and of HB in adult group was 81.8%.No statistical difference of occurrence rate of post-operational complications was detected in these two groups.Conclusion The predominant pathological type of tumors was PA in adolescent group and HB in adult group.Patients with PA and HB have a high resection rate and a good prognosis.However,the total medulloblastoma resection rate of adult and adolescent patients was low and the prognosis was even worse.
引文
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