100例神经母细胞瘤临床预后分析  

Clinical and Prognostic Analysis of 100 Patients with Neuroblastoma

作　　者：李忠元[1] 赵强[1] 王景福[1] 曹嫣娜[1] 李璋琳[1] 闫杰[1] 

机构地区：[1]天津市肿瘤防治重点实验室,天津医科大学附属肿瘤医院儿童肿瘤科,天津市300060

出　　处：《中国肿瘤临床》2011年第3期155-158,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨神经母细胞瘤(Neuroblastoma,NB)的临床特征、治疗方法及预后。方法:回顾性分析1995年4月至2009年8月天津医科大学附属肿瘤医院收治的并且随访资料完整的100例神经母细胞瘤患者的临床资料,比较不同因素对预后的影响。结果:中位随访期26.6个月(2～161个月);末次随访时CR 33例(33%),中位CR时间为14.4个月;带瘤生存病情稳定20例,总生存率(SR)53%。全组1、2及5年总生存率分别为93.5%、81.5%及33.6%。单因素分析发现:肿瘤是否原发纵隔、INSSⅢ+Ⅳ期、NSE>100μg/L、LDH>700U/L、骨髓以外转移、手术方式、病理类型为影响预后的因素。多因素分析显示:纵隔以外原发、是否完全切除肿瘤及LDH>700U/L为独立的预后影响因素。结论:原发于纵隔的神经母细胞瘤患者预后较其他部位好;神经母细胞瘤临床应采取手术、放疗及化疗为主的综合治疗,手术完整切除肿瘤可明显改善其预后;检测血清LDH对评估NB患者预后具有重要的意义。Objective： To investigate the clinical features, treatment and prognostic factors of patients with neuroblastoma. Methods： Clinical data of 100 patients with neuroblastoma with extensive follow-up, treated in our department between April 1995 and August 2009, were retrospectively analyzed and the prognostic factors were evaluated. Results： After a median follow-up of 26.6 months （ ranged 2 to 161 months ）, 33 cases had complete remission （CR） （median 14.4 months） and 20 cases had stable disease, with an overall survival rate （ SR ） of 53%. The 1-, 2-, and 5-year overall survival rates of the 100 patients were 93.5%, 81.5% and 33.6%, respectively. Univariate analysis revealed that the presence of tumor growing outside the mediastinum, INSS stage Ⅲ＋Ⅳ, NSE 〉 100 μg/L, LDH 〉 700 U/L, metastasis outside of the bone marrow, surgery and pathological type were prognostic factors. Multivariate analysis revealed that the presence of tumor growing outside of the mediastinum, tumor resectability and LDH 〉 700 U/L were independent prognostic factors. Conclusion： The prognosis for patients with neuroblastoma within the mediastinum is better than that for patients with neuroblastoma elsewhere in the body. Patients with neuroblastoma should be treated with combined therapy that includes surgery, radiotherapy and chemotherapy. Complete resection of the tumor significantly improves the prognosis. Detecting serum LDH level contributes to the determination of the prognosis for neuroblastoma patients.

关 键 词：神经母细胞瘤 临床特征 综合治疗 预后 

分 类 号：R739.4[医药卫生—肿瘤]