小儿神经母细胞瘤肺转移临床特征分析  

Clinical analysis of pulmonary metastases at diagnosis of neuroblastoma in pediatric patients

作　　者：刘颖[1] 孙艳丽[1] 程士凯[1] 付大军[1] 贺嘉[1] 王艳芳[1] 邹杰[1] 高英[1] 闻德亮[1] 张锦华[1] 

机构地区：[1]中国医科大学附属第四医院儿科,辽宁沈阳110032

出　　处：《现代肿瘤医学》2013年第3期604-607,共4页Journal of Modern Oncology

基　　金：辽宁省科学技术计划项目(编号:2010225001)

摘　　要：目的:分析小儿神经母细胞瘤肺转移的临床特征、治疗及预后。方法:对2008年3月至2012年3月中国医科大学附属第四医院儿科收治的5例神经母细胞瘤肺转移患儿的临床表现、影像学特征、治疗及预后进行分析。结果:在同期经病理确诊各期神经母细胞瘤102例,5例诊断肺转移,发病率为4.9%。胸部CT表现为肺内单发或多发、实性、磨玻璃密度或混合密度、边缘光滑或锐利、无钙化的结节,常伴胸膜转移。2例经化疗肺转移灶消失,1例完全缓解,另1例肺转移复发死亡。3例病情呈进行性恶化、死亡。结论:神经母细胞瘤肺转移无特异性临床表现,胸部CT有一定的特征,常规胸部CT检查有助于早期发现转移灶,化疗对肺转移有效,但可复发,神经母细胞瘤肺转移者预后不良。Objective： To analyze the clinical characteristics,treatment and prognosis of the rare occurrence of pul- monary metastases among children presenting with neuroblastoma（NB）. Methods： To analyze the clinical manifesta- tions,imaging characteristics, treatment and prognosis of 5 patients of neuroblastoma with pulmonary metastases who were treated by the Fourth Affiliated Hospital China Medical University Hospital from 2008.3 to 2012.3. Results： Of the 102 cases which were confirmed neuroblastoma in the same period ,5 patients were diagnosed with pulmonary me- tastases,the incidence was 4.9%. The chest CT showed the lesions could present as a solitary or multiple nodules with smooth or pointed margins,which were noncaleified and solid of ground - glass density or mixing density , often accompanied by pleural metastasis. Two casesg pulmonary metastases were disappeared after chemotherapy, and one of the two was recurrence , and ded. Three cases showed progressive deterioration and dead. Conclusion： There are no specific clinical manifestations of pulmonary metastases, chest CT has some characteristic features, routine chest CT examinations were helpful for the early detection of lung metastases, chemotherapy is effective for pulmonary metasta- ses,but relapse may happen, and the prognosis of NB children with pulmonary metastases is poor.

关 键 词：神经母细胞瘤 肺转移 儿童 

分 类 号：R729[医药卫生—儿科]