多形性黄色星形细胞瘤的临床诊治分析  

Analysis of clinical diagnosis and treatment of pleomorphic xanthoastrocytoma

作　　者：牛志强[1] 左争辉 屈洪彬 马春晓[3] NUI Zhi-qiang;ZUO Zheng-hui;QU Hong-bin;MA Chun-xiao(Department of Neurosurgery,Anyang Cancer Hospital,Anyang,Henan 455000,China;Department of Neurosurgery,Xuchang Central Hospital,Xuchang,Henan 461000,China;Department of Neurosurgery,Henan Provincial Peoples Hospital,Zhengzhou 450003,China)

机构地区：[1]安阳市肿瘤医院神经外科,河南安阳455000 [2]许昌市中心医院神经外科,河南许昌461000 [3]河南省人民医院神经外科,郑州450003

出　　处：《医药论坛杂志》2024年第6期615-619,共5页Journal of Medical Forum

摘　　要：目的研究多形性黄色星形细胞瘤(pleomorphic xanthoastrocytoma,PXA)的临床特点及治疗方法。方法回顾性分析2018年5月至2022年2月河南省人民医院和安阳市肿瘤医院神经外科收治的且经病理证实的15例PXA患者的临床资料,15例患者均在显微镜下行开颅手术治疗,通过分析患者的临床特点、影像学特征及治疗策略,总结了PXA的特点及治疗预后。结果15例PXA癫痫发作5例(33.3%),头痛5例(33.3%)。以颞叶为好发部位(53.3%),其次是额叶、顶叶和枕叶。影像学上肿瘤呈囊实性8例,多为成人;实性或以实性为主7例,多为儿童。肿瘤全切除12例(80%),部分切除3例(20%)。WHOⅡ级10例(66.7%),Ⅲ级5例(33.3%);术后行放化疗3例,行化疗2例。术后肿瘤复发2例(13.3%)。结论PXA以癫痫发作为主,颞叶最为常见;影像学上成人多以囊实性为主;儿童以实性为主,多伴囊性改变;临床上应积极手术治疗,全切除及病理级别与良好的预后相关,部分复发及具有恶变倾向者需辅助放化疗。Objective To analyze and discuss the clinical features and treatment of pleomorphic xanthoastrocytoma(PXA).Methods The clinical data of 15 patients with PXA confirmed by pathology in the Department of Neurosurgery of Anyang Cancer Hospital from May 2018 to Feb 2022 were retrospectively analyzed.All 15 patients underwent craniotomy under microscope.The clinical characteristics,imaging features and treatment strategies were analyzed.Results There were 5 cases(33.3%)of epilepsy and 5 cases(33.3%)of headache in 15 cases of PXA.Temporal lobe was the most common site(53.3%),followed by frontal lobe,parietal lobe and occipital lobe.In imaging,the tumors were cystic and solid in 8 cases,mostly in adults,and solid or mainly solid in 7 cases,mostly in children.Total resection was achieved in 12 cases(80%)and partial resection in 3 cases(20%).There were 10 cases(66.7%)of who gradeⅡ,5 cases(33.3%)of gradeⅢ,3 cases of postoperative chemoradiotherapy and 2 cases of chemotherapy.There were 2 cases(13.3%)of tumor recurrence after operation.Conclusion Epilepsy is the most common form of PXA,and temporal lobe is the most common.In imaging,adults are mostly cystic and solid;Children are mainly solid with cystic changes;Clinical treatment should be active.Total resection and pathological grade are related to good prognosis.Some patients with recurrence and malignant tendency need adjuvant chemotherapy and radiotherapy.

关 键 词：多形性黄色星形细胞瘤 临床特点 治疗措施 预后 

分 类 号：R739.4[医药卫生—肿瘤]