多形性黄色星形细胞瘤11例报道并文献复习  

11 cases pleomorphic yellow astrocytoma report and literature review

作　　者：米良[1] 杨海贵[1] 李海龙 郭志峰 皇甫罗锴 韩武 董超 张永兵[1] 王亚明 

机构地区：[1]延安市人民医院神经外科,陕西延安716000 [2]海军总医院神经外科三病区,北京100048

出　　处：《延安大学学报（医学科学版）》2017年第1期39-42,48,共5页Journal of Yan'an University:Medical Science Edition

摘　　要：目的探讨多形性黄色星形细胞瘤的临床特点及治疗效果。方法回顾性分析海军总医院11例经病理证实的多形性黄色星形细胞瘤的临床资料并复习相关文献。结果患者年龄14~73岁,平均31.8岁,临床表现以癫痫与头痛为主;颅脑MRI示9例位于大脑浅表部位;囊腔结节型7例,实质型3例,囊性1例;10例患者行开颅手术,其中全切8例,大部分切除2例,1例患者行脑立体定位活组织检查术,术中病理证实为肿瘤后直接行籽粒I125内放疗。术后辅助全脑放疗3例,其中同步放化疗2例。随访3月~6年,存活10例,术后4例复发,其中1例复发死亡。结论多形性黄色星形细胞瘤是一种相对良性肿瘤,多见于幕上浅表部位,临床症状以癫痫发作和头痛多见;手术全切,预后好,对手术有残留、复发或间变倾向者,辅助放疗,可减少复发率。Objective To explore the clinical characteristics of pleomorphic yellow astrocytoma and therapeutic effect.Methods 11 cases polymorphism of yellow astrocytoma confirmed by pathology were retrospectively analyzed the clinical data and review related literature.Results Patients aged 14 to 73 years,mean 31.8 years,the clinical manifestations of epilepsy and headache mainly; Brain magnetic resonance imagine（MRI） showed that 9 cases is in the shallow part of the brain; Cystic nodular 7 cases,3 cases of substantive,cystic in 1 case; 10 patients underwent craniotomy,of which 8 cases were total resection,most of the resection in 2 cases,1 case of brain biopsy,intraoperative pathology confirmed directly after the tumor row I125 intracoronary radiotherapy.Postoperative assisted whole brain radiotherapy in 3 cases,including simultaneous radiotherapy and chemotherapy in 2 cases.Follow-up of 3months to 6 years,10 cases of survival,4 cases of recurrence,of which 1 case of recurrence death.Conclusion Pleomorphic yellow astrocytoma is a relatively benign tumor,more common in superficial parts,and clinical symptoms are common in seizures and headaches; surgery with total removal is the major choice with good prognosis.Treatment of residual,recurrence or intermittent tendencies,adjuvant radiotherapy,can reduce the recurrence rate.

关 键 词：多形性黄色星形细胞瘤 脑肿瘤 胶质瘤 

分 类 号：R739.41[医药卫生—肿瘤]