儿童神经母细胞性肿瘤的临床特征及预后分析的单中心研究  

Single center study of clinical features and prognostic analysis of neuroblastie tumor in children

作　　者：肖慧[1] 郭霞[1] 万智[1] 艾媛[1] 杨雪[1] 孙舒雯 蒋呜艳 高举[1] 

机构地区：[1]四川大学华西第二医院儿童血液肿瘤科,成都610041

出　　处：《国际输血及血液学杂志》2017年第5期378-386,共9页International Journal of Blood Transfusion and Hematology

基　　金：四川省科技厅应用基础计划项目（2015JY0044）

摘　　要：目的分析儿童神经母细胞性肿瘤（NT）的临床特征及预后情况，探讨NT预后相关危险因素。方法选择2010年1月至2016年6月，于四川大学华西第二医院儿童血液肿瘤科收治的34例新发儿童NT患儿的临床病例资料为研究对象。对收集的34例新发儿童NT患儿的一般临床资料、辅助检查结果、肿瘤原发及转移部位、病理分型、MYCN基因扩增检测结果、临床分期与危险度分组、疗效及预后等情况进行回顾性分析。采用Kaplan-Meier法计算本研究34例儿童NT患儿的2年无事件生存（EFS）率和总体生存（OS）率，采用对数秩检验（log—ranktest）单因素分析影响其预后的影响因素，并采用Cox比例风险回归模型分析儿童NT预后的独立影响因素。本研究遵循的程序符合四川大学华西第二医院人体试验委员会所制定的伦理学标准，得到该委员会批准。结果①本研究34例儿童NT患儿中，男性患儿为13例（38．2％），女性为21例（61．8％）；中位发病年龄为40．5个月，发病年龄〉18个月患儿为28例（82．4％）；腹部包块（50．0％，17／34），发热（32．3％，11／34）和腹部疼痛（32．3％，11／34）是儿童NT最常见的就诊原因。②本研究34例儿童NT患儿中，原发于腹部患儿为28例（82．4％），原发于非腹部患儿为6例（17．6％）；初诊时骨髓转移患儿为16例（47．0％），骨骼转移患儿为10例（29．4％），颈部淋巴结转移（原发于纵隔）患儿为3例（8．8％），脾、肺转移患儿各为1例（2．9％）。③血常规检查结果显示，贫血患儿为18例（52．9％）；17例儿童NT患儿行血清神经元特异性烯醇化酶（NSE）检测，其血清NSE水平为27．28～370．00ng／mL。④本研究34例儿童NT患儿中，14例（41．2％）患儿的肿瘤最大直径〉9cm；影像学检查结果显示，肾上腺区包块患儿为18例（52．9％），腹膜后包块患儿为10�Objective To analyze the clinical features and clinical outcomes of pediatric neuroblastic tumor（NT）, and to document prognosis-related risk factors of pediatric NT. Methods From January 2010 to June 2016,clinical data of 34 new-onset pediatric NT patients were enrolled in this study. Their general clinical data,results of auxiliary examination, primary site and metastasis site, pathological type, MYCN amplification test results, clinical stage and risk group, treatment, efficacy and prognosis of patients with pediatric NT were analyzed retrospectively. Two-year event-free survival （EFS） rates and overall survival （OS） rates were calculated by the Kaplan-Merire method. Univariable analysis by log-rank test was undertaken to identify prognosis-related influence factors and multivariable analysis by the Cox proportional hazards regression model was for independent prognosis-related influence factors. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital, Sichuan University. Results ① Among 34 pediatric NT patients, there were 13 male patients （38.2%） and 21 female patients （61.8%）. Median age of them at diagnosis was 40. 5 months, with 28 cases having age of onset over 18 months. Abdominal mass （50.0%, 17/34） , fever （32.3%, 11/34） and abdominal pain （32.30/00, 11/34） were the leading causes of seeking medical care. ② Among 34 pediatric NT patients, 28 cases （82.3%） were primary abdominal mass, 6 cases （17.6%） occurred in non-abdomen. At diagnosis, there were 16 cases （47.0%） with bone marrow metastasis,10 cases （29.4%） with skeletal metastasis, 3 cases （8.8 % ） with cervical lymph nodes metastasis, while spleen and lung metastasis occurred both in one case （2.9%）. ③ Routine blood test results showed 18 cases （52.9%） had anemia. Seventeen cases finished serum neuron-specific enolase （NSE） test, whose serum NSE level were 27.28- 370.00 ng/mL. ④ The maximum diameter o

关 键 词：神经母细胞瘤 临床特征 预后因素 儿童 

分 类 号：R739.4[医药卫生—肿瘤]