多基因联合检测化疗对进展期儿童神经母细胞瘤手术治疗及预后的影响  

Effect of combined Detection of Multiple Genes on Surgical Treatment and Prognosis of Advanced Neuroblastoma in Children

作　　者：吴宙光[1] 王斌[1] 陈子民[1] 冯奇[1] 郑佳辰 符策君[2] 董琦[2] WU Zhouguang;WANG Bin;CHEN Zimin(Shenzhen Children's Hospital,Shenzhen,518026)

机构地区：[1]深圳市儿童医院,518026 [2]海南省人民医院,570208

出　　处：《实用癌症杂志》2020年第7期1157-1161,共5页The Practical Journal of Cancer

基　　金：2017年度国家自然科学基金资助项目(编号:81770512);2018年度深圳市医疗卫生三名工程(编号:SZSM201812055)。

摘　　要：目的探讨多基因联合检测化疗对进展期神经母细胞瘤手术治疗及患儿预后的影响。方法选取首诊的进展期儿童神经母细胞瘤病例65例,根据是否愿意进行多基因检测进行分组,分为多基因检测联合化疗组和常规化疗组,并且分为中危及高危组,中危患儿采用OPEC/OPAC或CAV/EP方案交替使用;而高危患儿采用CT/OPEC/OPAC交替使用,根据多基因联合检测的结构采取敏感的化疗药物。多基因检测联合化疗组平均化疗3~6次后手术治疗,常规化疗组化疗次数大多数在4~9次后进行手术治疗。结果多基因检测联合化疗组肿瘤缩小率为89.67%;常规化疗组肿瘤缩小率为79.48%。多基因检测联合化疗组患儿肿瘤完全切除率为40%,肿瘤切除率为96.7%。常规化疗组患儿肿瘤完全切除率为25.7%,切除率为57.14%。多基因联合化疗组总体3年生存率为90%,中危组3年生存率为100%,高危组3年生存人数为13例,生存率为81.25%;常规化疗组总体3年生存率为74.29%,中危组生存人数为17例,生存率为94.4%,而高危组生存人数为9例,生存率为52.94%。由此可见,中危患者的生存率无明显差异(P>0.05),高危患者经过多基因检测联合化疗后的生存率明显高于常规化疗组(P<0.05)。结论多基因联合检测化疗能够有效延长进展期神经母细胞瘤高危组患儿的生存率。Objective To investigate the effect of multigene combined chemotherapy on the surgical treatment and prognosis of advanced neuroblastoma in children.Methods 65 cases of progressive neuroblastoma in children were divided into 2 groups according to their willingness to carry out multi-gene detection,namely,multi-gene detection combined with chemotherapy group and routine chemotherapy group,and divided into medium-risk and high-risk group.OPEC/OPAC or CAV/EP regimen were used alternately in medium-risk children,while CT/OPEC/OPAC regimen was used in high-risk children.Sensitive chemotherapy drugs were uesd in which were based on the structure of multi gene combined detection.The average number of chemotherapy was3~6 times in the polygenic test group,and at the same time 4~9 times was used in the conventional chemotherapy group.Results The tumor shrinkage rate was 89.67%in the combined chemotherapy group and it showed 79.48%in the conventional chemotherapy group.The rate of total tumor resection was 40%and the rate of partial resection of tumor was 96.7%.In the conventional chemotherapy group,the total tumor resection rate was 25.7%,and the resection rate was 57.14%.The overall 3-year survival rate was 90%in the polygenic combination chemotherapy group,100%in the middle-risk group,and 81.25%in the high-risk group.The overall 3-year survival rate was 74.29%in the conventional chemotherapy group,and 94.4%in the middlerisk group,while in the high-risk group was 52.94%.Therefore,there was no significant difference in survival rate between the middle-risk group and the high-risk group(P>0.05).The survival rate of the high-risk group was significantly higher than that the conventional chemotherapy group(P<0.05).Conclusion Chemotherapy combined with polygenic detection can effectively enhanced the survival rate of children who are involved in advanced neuroblastoma in high-risk group.

关 键 词：基因 化疗 儿童 神经母细胞瘤 预后 手术 

分 类 号：R730.264[医药卫生—肿瘤]