摘要
目的探讨松果体区非生殖细胞瘤性恶性生殖细胞肿瘤（NGMGCTs）的临床特点、治疗和预后。方法回顾性分析了2000年1月至2010年1月经病理证实的34例高度恶性NGMGCTs患者的临床特点、血清肿瘤标记物检测、治疗方法及预后。所有患者均行枕部经小脑幕（Poopen）入路显微手术切除肿瘤，并行辅助放化疗。结果全切除32例，近全切除2例，术后病理示未成熟畸胎瘤11例，畸胎瘤恶性变2例，胚胎癌2例，卵黄囊瘤1例，绒毛膜上皮癌6例，混合性生殖细胞肿瘤12例。共随访31例患者，随访时间6个月至10年，1年生存率为97％，3年生存率为62％，5年生存率为44％。结论多数松果体区NGMGCTs根据临床表现、影像学资料和肿瘤标记物可在术前定性，以手术为主术后辅以化疗和放疗的综合治疗可以获得良好疗效。
Objective To investigate the clinical feature, treatment and prognosis of intracranial nongerminomatous malignant germ cell tumors （NGMGCTs） in pineal region. Methods Records of 34 such kind patients treated in our hospital between Jan 2000 and Jan 2010 were reviewed retrospectively. Clinical manifestations, diagnosis, treatment and outcome were analyzed in each patient. All tumors were microsurgically removed by occipital transtentorial approach （Poppen） and treated with radiotherapy combined chemotherapy. Results The tumor was totally removed in 32 cases, sub - totally in 2. In these 34 cases, all were verified by pathology, viz. 11 immature teratomas, 2 teratoma with malignant transformation, 6 choriocarcinoma, 2 embryonal carcinomas and 1 yolk sac tumors, 12 mix germ cell tumors. Thirty - one patients were followed up. The overall 1 - year survival rate was 97% , 3 - year survival rate 62% and 5 - year survival rate 44%. Immature teratomas 1 - year survival rate was 100% , 3 - year survival rate 67%. Teratoma with malignant transformation 1 - year survival rate was 100% , 1 - year survival rate was 33%. Chorioeareinoma, embryonal carcinomas and yolk sac tumors 1 - year survival rate was 88% , 3 - year survival rate 55% , 5 - year survival rate 33%. Mix germ cell tumors 1 - year survival rate was 100% , 3 - year survival rate 67%, 5 - year survival rate 67%. Conclusion The majority of pineal region NGMGCTs can be diagnosed by clinical manifestations, imaging data and tumor markers pre -operatively Surgery remains the first choice for NGMGCT based on tumor histology. Combined regimen of surgical resection, radiotherapy and chemotherapy is mostly effective.
出处
《中华神经外科杂志》
CSCD
北大核心
2011年第10期1016-1019,共4页
Chinese Journal of Neurosurgery
关键词
松果体区
生殖细胞肿瘤
诊断
治疗
Pineal region
Germ cell tumors
Prognosis
Treatment
