婴儿神经母细胞瘤44例临床特点及预后分析  

Clinical characteristics and prognosis of 44 cases of infantile neuroblastoma

作　　者：贺嘉[1] 刘颖[1] 黄康[1] 付大军[1] 程士凯[1] He Jia;Liu Ying;Huang Kang;Fu Dajun;Cheng Shikai(Department of Pediatrics,The Fourth Affiliated Hospital of China Medical University,Shenyang 110032,Liaoning Province,China)

机构地区：[1]中国医科大学附属第四医院儿科,沈阳110032

出　　处：《中国基层医药》2022年第4期490-494,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：辽宁省沈阳市科学技术计划项目(F13-221-9-43)。

摘　　要：目的探讨婴儿神经母细胞瘤(NB)的临床特点及影响预后的因素。方法回顾性分析中国医科大学附属第四医院儿科2008年3月至2017年3月收治的婴儿NB 44例的临床资料,总结临床特点并分析影响预后的因素。结果44例患儿中,男21例,女23例,中位年龄5.5个月(范围0 d至12个月)。Ⅰ期4例,Ⅱ期7例,Ⅲ期5例,Ⅳ期15例,Ⅳs期13例。肿瘤原发部位:肾上腺和腹膜后26例(59.1%),后纵隔15例(34.1%),盆腔2例(4.5%),颈部1例(2.3%)。中位随访时间90个月(范围2~144个月),3年、5年总生存率分别为93.2%、90.9%,生存时间5年以上患儿35例,其中30例健康存活,5例带瘤生存,死亡4例。骨髓和骨转移、肿瘤切除完整程度明显影响预后(χ^(2)=6.92、12.19、4.70,均P<0.05)。结论婴儿NB总体预后好,原发部位以腹部多见。Ⅳs期患儿的生存率低于Ⅰ期、Ⅱ期及Ⅲ期,腹部NB预后较其他部位差。骨转移、骨髓转移、肿瘤切除完整程度是影响预后的不良因素。Objective To investigate the clinical characteristics of infantile neuroblastoma(NB)and the factors that affect prognosis.Methods We retrospectively analyzed the clinical data collected from 44 cases of NB who received treatment in The Fourth Affiliated Hospital of China Medical University from March 2008 to March 2017 to summarize the clinical characteristics of NB and the factors that affect prognosis.Results Among the 44 cases,21 were male and 23 were female,with a median age of 5.5 months(range,0 days-12 months).Four cases had stage I NB,seven cases stage II NB,five cases stage III NB,15 cases stage IV NB,and 13 cases stage IVs NB.The tumors were located in the adrenal glands and retroperitoneum(n=26,59.1%),posterior mediastinum(n=15,34.1%),pelvis(n=2,4.5%),and neck(n=1,2.3%).The median follow-up time was 90 months(range,2-144 months).The 3-year and 5-year overall survival rates were 93.2%and 90.9%,respectively.Among 35 cases who survived more than 5 years,30 cases survived healthily,5 cases survived with tumor,and 4 cases died.Bone marrow metastasis,bone metastasis,and the extent of tumor resection greatly affect the prognosis of NB(χ^(2)=6.92,12.19,4.70,all P<0.05).Conclusion The overall prognosis of NB is good in infants.NB mainly occurs in the abdomen.The survival rate of infants with stage IVs NB is lower than that of infants with stages I,II,and III NB.The prognosis of NB occurring in the abdomen is poorer than that occurring in other regions.Bone marrow metastasis,bone metastasis,and the extent of tumor resection are adverse factors affecting the prognosis.

关 键 词：神经母细胞瘤 疾病特征 预后 危险因素 肿瘤转移 生存率 婴儿 回顾性研究 

分 类 号：R739.4[医药卫生—肿瘤]