脊髓髓内高级别星形细胞瘤的预后因素分析  

Prognostic analyses of intramedullary high grade astrocytomas

作　　者：顾文韬[1] 顾士欣[1] 寿佳俊[1] 车晓明[1] 

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《中华医学杂志》2014年第19期1455-1458,共4页National Medical Journal of China

摘　　要：目的 探讨脊髓髓内高级别星形细胞瘤的预后影响因素.方法 回顾性分析复旦大学附属华山医院神经外科2008至2012年手术治疗的脊髓髓内高级别星形细胞瘤患者病例资料并随访,对手术效果及预后进行综合分析.结果 显微手术治疗21例患者,其中间变星形细胞瘤14例,胶质母细胞瘤7例.平均年龄32.5岁.高级别胶质瘤患者预后与病理学级别及MIB-1指数显著相关（P＜0.05）,与年龄、性别、McCormick评分、肿瘤切除程度、放疗、化疗等差异无统计学意义（P＞0.05）.结论 脊髓髓内高级别胶质瘤患者发病率低,预后差.对于术前考虑该诊断的患者,建议早期手术,术中快速冰冻检查,并根据肿瘤界面等因素决定手术切除程度,术后可予辅助性放疗和化疗.Objective To explore the prognostic factors of intramedullary high grade astrocytomas.Methods Retrospective analyses were conducted for 21 surgical patients with high grade astrocytoma in spinal cord during 2008 to 2012 at our hospital.Their preoperative and postoperative profiles were recorded and evaluated by modified McCormick classification scheme.Results Their median age was 32.5 years.There were anaplastic astrocytoma （n =14） and glioblastoma （n =7）.The prognoses of high grade astrocytomas were correlated with pathology grade and MIB-1 index.No statistic significance existed in age,gender,McCormick score,extent of resection,radiotherapy or chemotherapy.Conclusion Intramedullary high grade astrocytoma has a low incidence,but its outcome is poor.Once definitely diagnosed,operation is recommended as early as possible.Frozen pathology should be performed to determine the extent of resection.After operation,chemotherapy and radiotherapy are also suggested.

关 键 词：脊髓 星形细胞瘤 高级别 

分 类 号：R739.42[医药卫生—肿瘤]