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机构地区:[1]广西壮族自治区人民医院神经外科,广西南宁530021
出 处:《中华神经外科疾病研究杂志》2013年第4期341-344,共4页Chinese Journal of Neurosurgical Disease Research
摘 要:目的探讨颅内血管外皮细胞瘤的诊断与治疗。方法回顾性地对我院神经外科收治的颅内血管外皮细胞瘤18例患者的临床特点、诊断、治疗和预后进行分析。结果 18例患者中,男女比例为1.57∶1,平均年龄46.3岁。主要临床表现为头痛(77.8%)及局部神经系统症状。术前所有病例均未确诊,术中冰冻切片获得倾向性诊断,细胞学及免疫组化确诊。所有肿瘤均为单发,最大径平均为5.6 cm。免疫组化CD34阳性率为88.9%,波形蛋白(Vim)除1例不确定外,余均为阳性,一半的病例增殖细胞核抗原(Ki-67)为阳性,上皮膜抗原(EMA)均为阴性。全切10例(55.6%),次全切8例(46.6%),12例(66.7%)术后1个月内辅以立体定向γ-刀放射治疗。术后均获随访,随访期为1.5~10年。至今12例原位复发,无远处转移。结论颅内血管外皮细胞瘤术前诊断相当困难,目前主要依赖病理学检查,治疗上应旨在手术全切,术后辅以放疗。Objective To investigate the diagnosis and treatment of intracranial hemangiopericytoma (HPC). Methods The clinical features, diagnosis, treatment and prognosis of 18 HPCs were analyzed retrospectively. Results Among 18 eases, the male-female ratio was 1.57: 1 with a mean age of 46. 3 years. The principal clinical manifestations were headache (77. 8% ) and local neurological symptoms. No patient obtained the definitive diagnosis pre-operation. However, tendentious diagnosis was obtained by intra-operative frozen sections, which was confirmed by cytology and immunohistocherrfistry. Solitary lesion was observed in all patients, with an average tumor size of 5.6 cm. The positive rate of CD34 was 88.9% by inmaunohistochemistry, and the vimentin (Vim) were positive in all cases, except 1 case of uncertain; half of patients showed Ki-67 positive staining and all were negative of epithelial membrane antigen (EMA). For all patients there were 10 cases of total resection (55.6%) and 8 cases of subtotal resection (46. 6% ). Twelve cases were performed adjuvant γ-knife radiotherapy within 1 month after surgery. All cases were followed up (range, 1.5 to 10 years), and 12 cases got local recurrence and no distant metastasis. Cortelusion Pre-operative diagnosis of HPC is very difficult and the definitive diagnosis mainly depends on pathological examination. The treatment should be aimed at total resection and adjuvant radiotherapy.
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