髓母细胞瘤预后因素分析  

Analysis of prognostic factors in medulloblastoma

作　　者：张庆慧[1] 梁思泰[1] 苏晓萍[1] 李红[1] 谭燕泉[1] 

机构地区：[1]山东医科大学附属医院病理科

出　　处：《临床与实验病理学杂志》1998年第4期353-355,共3页Chinese Journal of Clinical and Experimental Pathology

基　　金：国家自然科学基金

摘　　要：目的：分析影响小脑髓母细胞瘤（ＭＢ）预后的因素。方法：对９９例小脑ＭＢ进行临床病理形态学观察及ＰＣＮＡ、Ｓｙｎ、ＮＦＰ和ＧＦＡＰ免疫组化ＡＢＣ法标记。采用单因素ｌｏｇ－ｒａｎｋ检验及多因素Ｃｏｘ风险回归模型进行预后分析。结果：单因素分析显示年龄＞１８岁（Ｐ＜０．０５）、促纤维增生型ＭＢ（Ｐ＜０．０５）、肿瘤无灶状坏死（Ｐ＜０．００１）、ＰＣＮＡ标记指数低（Ｐ＜０．０５）及术后进行放射治疗（Ｐ＜０．００１）的病人预后好。多因素分析显示术后未进行放疗（Ｐ＜０．００１）、肿瘤有灶状坏死（Ｐ＜０．００１）、ＰＣＮＡ标记指数高（Ｐ＜０．０５）、经典型ＭＢ（Ｐ＜０．０５）、年龄＜１８岁（Ｐ＜０．０５）及分裂象计数高（Ｐ＜０．０５）是６个影响ＭＢ预后的危险因素。结论：年龄、组织类型、细胞增殖活性。Purpose To evaluate the factors that affect the prognosis of cerebullar medulloblastoma. Methods 99 cases of medulloblastoma were observed with histological and immunohistochemical ABC method. Clinicopathological and therapeutic factors were evaluated with simple and multivariate analysis with regard to prognosis. Results With simple analysis, five factors showed high significance to long survival: age >18 years ( P< 0 05), desmoplastic type of medulloblastoma ( P< 0 05), no necrosis ( P< 0 001), lower PCNA index ( P< 0 05) and receiving postoperative radiation treatment ( P< 0 001). Multivariate analysis, six factors showed significant dangerous to survival: no radiation therapy ( P< 0 001), focal necrosis of tumor ( P< 0 001), high PCNA index ( P< 0 05), classical medulloblastoma ( P< 0 05), age <18 years ( P< 0 05), high mitotic figure count ( P< 0 05). Conclusion The age of the patient, histological type, necrosis of tumor, PCNA index and radiation thearpy are the main factors that predicate the prognosis of medulloblastoma patient.

关 键 词：小脑肿瘤 成神经管细胞瘤 髓母细胞瘤 MB 

分 类 号：R739.410.2[医药卫生—肿瘤]