儿童中枢神经系统肿瘤163例临床分析
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摘要
目的探讨儿童中枢神经系统肿瘤的发病特点、临床表现、病理学特点及其相互关系。方法2002年1月~2012年12月期间,年龄<16岁,经手术取材获得组织病理学诊断的中枢神经系统肿瘤患者共163例,按照WHO 2007年中枢神经系统肿瘤分类,进行回顾性分析。结果颅内和椎管内肿瘤分别为151例(92.64%)和12例(7.36%),幕上80例(52.98%),幕下71例(47.02%)。男96例,女67例,发病比例为1.43∶1,各年龄段均有发病,随年龄的增长肿瘤发病率呈增高趋势。颅内最常见的五种肿瘤类型依次是星形细胞瘤53例(33.74%)、髓母细胞瘤29例(17.79%)、脑膜瘤17例(10.43%)、颅咽管瘤12例(7.36%)及少突胶质细胞瘤11例(6.75%)。椎管内最常见的是生殖细胞肿瘤(41.67%)。结论儿童中枢神经系统肿瘤发病以星形细胞瘤最常见,幕上多于幕下,男性居多,临床表现与肿瘤部位及年龄相关。
Objective To investigate the incidence,clinical symptoms,pathological characteristics and their mutual relations of central nervous system tumors in childhood. Methods During the period from 2002 to 2012,163 cases of central nervous system tumors of children( ≤16years) were retrospectively analyzed according to WHO 2007 classification. Results Intracranial and spinal tumors were 151 cases( 92. 64%) and 12 cases( 7. 36%),supratentorial 80cases( 52. 98%),infratentorial 71 cases( 47. 02%). Male 96 cases,female 67 cases,the incidence rate was 1. 43 ∶ 1,and the incidence increased with age growing. The most common types of intracranial tumor followed by astrocytoma 53 cases( 33. 74%),medulloblastoma 29cases( 17. 79%),meningioma 17 cases( 10. 43%),craniopharyngioma 12 cases( 7. 36%)and oligodendroglioma 11 cases( 6. 75%). The most common types of spinal cord tumor was germ cell tumors( 41. 67%). Conclusion The most common type of childhood nervous system tumors is astrocytoma,supratentorial is more than infratentorial,mostly male. The clinical features are related with tumor location and age.
Objective To investigate the incidence,clinical symptoms,pathological characteristics and their mutual relations of central nervous system tumors in childhood. Methods During the period from 2002 to 2012,163 cases of central nervous system tumors of children( ≤16years) were retrospectively analyzed according to WHO 2007 classification. Results Intracranial and spinal tumors were 151 cases( 92. 64%) and 12 cases( 7. 36%),supratentorial 80cases( 52. 98%),infratentorial 71 cases( 47. 02%). Male 96 cases,female 67 cases,the incidence rate was 1. 43 ∶ 1,and the incidence increased with age growing. The most common types of intracranial tumor followed by astrocytoma 53 cases( 33. 74%),medulloblastoma 29cases( 17. 79%),meningioma 17 cases( 10. 43%),craniopharyngioma 12 cases( 7. 36%)and oligodendroglioma 11 cases( 6. 75%). The most common types of spinal cord tumor was germ cell tumors( 41. 67%). Conclusion The most common type of childhood nervous system tumors is astrocytoma,supratentorial is more than infratentorial,mostly male. The clinical features are related with tumor location and age.
引文
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[2]Schultz KP,Ness KK,Whitton J,et al.Behavioral and social outcomes in adolescent survivors of childhood cancer:A report from the childhood cancer survivor study[J].J Clin Oncol,2007,25(24):3649-3656.
[3]Louis DN,Ohgaki H,Wiestler OD,et al.The 2007 WHO classification of tumors of the central nervous system[J].Acta Neuropathol,2007,114(2):97-109.
[4]Fuller GN,Scheithauer BW.The 2007 Revised World Health Organization(WHO)Classification of Tumors of the Central Nervous System:newly codified entities[J].Brain Pathol,2007,17(3):304-307.
[5]Kaatsch P,Rickert CH,Kühl J,et al.Population-based epidemiologic data on brain tumors in German children[J].Cancer,2001,92(12):3155-3164.
[6]汤磊,蒋莉.小儿颅脑肿瘤98例[J].实用儿科临床杂志,2009,24(7):548-550.
[7]Zhou D,Zhang Y,Liu H,et al.Epidemiology of nervous system tumors in children:a survey of 1,485 cases in Beijing Tiantan Hospital from 2001 to 2005[J].Pediatr Neurosurg,2008,44(2):97-103.
[8]Rickert CH,Paulus W.Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification[J].Childs Nerv Syst,2001,17(9):503-511.
[9]Cho KT,Wang KC,Kim SK,et al.Pediatric brain tumors:statistics of SNUH,Korea(1959-2000)[J].Childs Nerv Syst,2002,18(1-2):30-37.
[10]Sklar CA.Childhood brain tumors[J].J Pediatr Endocrinol Metab,2002,15(Suppl 2):669-673.
[11]Mehrazin M,Yavari P.Morphological pattern and frequency of intracranial tumors in children[J].Childs Nerv Syst,2007,23(2):157-162.
[12]周大彪,罗世祺,马振宇,等.1267例儿童神经系统肿瘤的流行病学[J].中华神经外科杂志,2007,23(1):4-7.
[13]陈宏,吴劲松,陈衔城,等.儿童中枢神经系统肿瘤(附766例分析)[J].中国临床神经科学,2001,9(3):262-263.
[14]Chan MY,Teo WY,Seow WT,et al.Epidemiology,management and treatment outcome of medulloblastoma in singapore[J].Ann Acad Med Singapore,2007,36(5):314-318.
[15]Reulecke BC,Erker CG,Fiedler BJ,et al.Brain tumors in children:initial symptoms and their influence on the time span between symptom onset and diagnosis[J].J Child Neurol,2008,23(2):178-183.
[16]程阳泉,阚志生,罗世祺.儿童颅内畸胎瘤84例临床分析[J].中华小儿外科杂志,1996,17(6):330-332.