胚胎发育不良性神经上皮肿瘤伴发癫痫的影响因素研究  

Influencing factors of dysembryoplastic neuroepithelial tumor associated with epilepsy

作　　者：杨帆[1] 丁成赟 张星虎[3] YANG Fan;DING Chengyun;ZHANG Xinghu(Department of Rehabilitation,China Rehabilitation Research Center,Beijing Bo'ai Hospital,Beijing 100068,China;Department of Neurology,Shenzhen Longhua District Ping’an Hospital,Guangdong,Shenzhen 518110,China;Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]中国康复研究中心北京博爱医院综合康复科,北京100068 [2]深圳市龙华区平安医院神经内科,广东深圳518110 [3]首都医科大学附属北京天坛医院神经内科,北京100050

出　　处：《中国现代医生》2022年第27期112-116,142,共6页China Modern Doctor

摘　　要：目的探讨胚胎发育不良性神经上皮肿瘤(dysembryoplastic neuroepithelial tumor,DNET)伴发癫痫的多种因素对其预后的影响,以期对该病的术前评估及预后提供指导。方法回顾性选取2005年12月至2017年12月于首都医科大学附属北京天坛医院神经外科行手术治疗的80例DNET患者,收集患者的一般资料、病史资料、辅助检查资料、治疗方案等,分析其与术后癫痫控制的统计学相关性。DNET伴发癫痫影响因素的评价采用多因素Logistic回归分析。结果80例患者的癫痫发作年龄为12.00(7.00,19.50)岁,70%(56/80)的患者癫痫发作年龄≤18岁,病程为21.00(4.00,72.00)个月。最常见的癫痫发作类型是复杂部分性发作(38.8%,31/80)。所有肿瘤均为单发,均位于幕上,以颞叶最多见,达43.8%(35/80)。61例患者进行肿瘤全切术或扩大切除术(76.3%)。平均随访时间(44.7±25.4)个月,随访期间所有患者均无肿瘤复发,80例患者达1年随访,EngelⅠ级和Ⅱ级(代表预后良好)达88.8%(71/80)。多因素Logistic回归分析显示,病程(P=0.04)、手术方式(P=0.029)与预后(Engel分级)具有相关性。结论胚胎发育不良性神经上皮肿瘤的病程长短与术后癫痫发作有关,肿瘤全切术是控制癫痫发作的重要因素。Objective To investigate the influencing factors on the prognosis of dysembryoplastic neuroepithelial tumor(DNET)associated with epilepsy,in order to provide guidance for the preoperative evaluation and prognosis.Methods A total of 80 patients with DNET who underwent surgical treatment in the Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University from December 2005 to December 2015 were retrospectively selected.The general information,medical history data,auxiliary examination data and treatment plan of the patients were collected,and analyzed for statistical association with postoperative seizure control.Multivariate Logistic regression analysis was used to evaluate the influencing factors of DNET associated with epilepsy.Results The age of onset in 80 patients was 12.00(7.00,19.50)years old,70%(56/80)of the patients were≤18 years,and the disease duration was 21.00(4.00,72.00)months.The most common type was complex partial seizures(38.8%,31/80).All of the tumors were solitary,and all located in the supra tentorial areas,temporal lesions accounted for 43.8%(35/80)of cases.61 patients took complete or extended resection(76.3%).The median overall follow-up duration was(44.7±25.4)months,no patient had recurrence during the follow-up duration.At 1 year,88.8%(71/80)of patients had EngelⅠ/Ⅱclassification outcome(estimates good outcomes).Multivariate Logistic regression analysis showed that,the course of disease(P=0.04),surgical method(P=0.029)associated with prognosis(EngelⅠclassification).Conclusion The course of the disease is related to postoperative seizure.Total tumor resection is an important factor in controlling seizure.

关 键 词：胚胎发育不良性神经上皮肿瘤 癫痫 结局 预后因素 

分 类 号：R739.4[医药卫生—肿瘤] R742[医药卫生—临床医学]