7例成人神经节细胞胶质瘤的影像表现、病理特征及手术效果分析  

Neuroimaging findings, pathological features and surgical efficacy of adult gangliogliomas

作　　者：马木提江·木尔提扎 汪永新[1] 范雁东[1] 秦虎[1] 马倩[2] Mamutijiang Muertizha;Wang Yongxin;Fan Yandong;Qin Hu;Ma qian(Department of Neurosurgery,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Pathology,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院神经外科,乌鲁木齐830054 [2]新疆医科大学第一附属医院病理科,乌鲁木齐830054

出　　处：《中华神经医学杂志》2022年第9期929-933,共5页Chinese Journal of Neuromedicine

摘　　要：目的探讨成人神经节细胞胶质瘤的影像表现、病理特征及手术效果。方法选择新疆医科大学第一附属医院神经外科自2010年8月至2021年12月手术治疗的7例成人神经节细胞胶质瘤患者进行研究,回顾性分析其临床资料,并总结神经节细胞胶质瘤的CT、MRI表现及组织病理学特征以及手术效果。结果7例患者中,肿瘤为实性肿块型1例、囊实性肿块型4例、弥漫浸润型2例;实性部分在CT上呈稍低或等密度影,在MRI上多为T1稍低信号、T2稍高信号、T2 FLAIR高或稍高信号、DWI等或稍低信号。免疫组化染色显示肿瘤标本中胶质细胞成分胶质纤维酸性蛋白、少突胶质细胞转录因子、S-100蛋白表达阳性,神经节细胞成分神经元核抗原、突触素表达阳性。肿瘤全切5例、次全切1例、部分切除1例,非全切者均为弥漫浸润型。患者术后Karnofsky功能状态评分中位数为80分,随访7个月~11年均无死亡病例。结论成人神经节细胞胶质瘤在影像上多呈边界清楚的囊实性病灶,混合肿瘤性神经节细胞和胶质细胞的组织病理学特点为其主要诊断依据,手术效果通常较好,但弥漫浸润型全切难度较大。Objective To investigate the clinical characteristics,pathological features and surgical efficacy of adult gangliogliomas.Methods Seven patients with gangliogliomas underwent surgical treatment in our hospital from August 2010 to December 2021,were chosen;their clinical data were retrospectively analyzed,and the CT and MRI manifestations and histopathological features of gangliogliomas and surgical efficacy of these patients were concluded.Results In these 7 patients,solid-mass type was identified in 1 patient,cystic-solid mixed type in 4 patients,and diffuse infiltrating type in 2 patients.The solid part showed slightly low or equal density on CT,and mostly showed slightly low signal on T1,slightly high signal on T2,high or slightly high signal on T2 FLAIR,and equisignal or slightly low signal on DWI of MRI.Immunohistochemical staining showed that in the tumor specimens,glial cell components were positive for glial fibrillary acidic protein,oligodendrocyte transcription factor and S-100 protein,and ganglion cell components were positive for neuronal nuclear antigen and synaptophysin.Gross total resection was achieved in 5 patients,subtotal resection in 1 patient,and partial resection in 1 patient;gangliogliomas without total resection were diffuse infiltrative type.The median Karnofsky performance status scores were 80.There was no death during the follow-up period of 7 months-11 years.Conclusions Adult gangliogliomas are mostly cystic and solid lesions with clear boundary on imaging,and the histopathological characteristics of mixed neoplastic ganglion cells and glial cells are the main basis for their diagnosis.The surgical efficacy is usually good,but the diffuse infiltrating type is difficult to achieve total resection.

关 键 词：神经节细胞胶质瘤 影像表现 病理特征 手术效果 

分 类 号：R739.41[医药卫生—肿瘤]