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目的探讨颅内原发生殖细胞瘤的临床特征。方法收集华西医院脑外科2000年1月-2009年3月119例颅内原发生殖细胞瘤的临床资料进行回顾性分析。结果发病率约占同期颅内肿瘤的1.1%。男∶女=1.64∶1,平均发病年龄15.4岁。临床表现主要为颅内高压症状及视力视野改变,分别为61、56例;肿瘤主要来源于松果体区及鞍区;64例患者行放疗或放疗加化疗,随访45例。55例患者行手术治疗(其中术后行单纯放疗19例,放疗加化疗5例),随访36例。随访时间3～94个月,平均29.7个月。行放疗和放化疗的患者3、5年生存率明显高于单纯行手术治疗的患者。结论颅内原发生殖细胞瘤多见于儿童及青少年,男性多见,肿瘤大多位于松果体区及鞍区。临床表现位于松果体区者主要为颅内高压症状等,位于鞍区者主要为视力视野改变、尿崩等。放疗联合化疗是主要治疗手段。
Objective To investigate the clinical features of intracranial primary germinoma. Methods The clinical data of 119 patients with intracranial primary germinomas from January 2000 to March 2009 in Department of Brain Surgery, West China Hospital were retrospectively analyzed. Results The incidence rate of about 1.1% of intracranial tumors in the same period. Male: Female = 1.64: 1, the average age of onset 15.4 years old. Clinical manifestations mainly for intracranial hypertension symptoms and visual field changes, respectively, 61,56 cases; tumors mainly come from the pineal region and the saddle area; 64 patients underwent radiotherapy or radiotherapy plus chemotherapy, followed up 45 cases. 55 patients underwent surgical treatment (including 19 cases of postoperative radiotherapy alone, radiotherapy and chemotherapy in 5 cases), followed up for 36 cases. Follow-up time of 3 to 94 months, an average of 29.7 months. The 3-year and 5-year survival rate of patients undergoing radiotherapy and chemotherapy was significantly higher than that of patients undergoing simple surgical treatment. Conclusion The intracranial primary germ cell tumor is more common in children and adolescents, more common in men, the tumors are mostly located in the pineal region and the saddle area. Clinical manifestations in the pineal region were mainly intracranial hypertension symptoms, located in the saddle area mainly for visual field changes, diabetes insipidus and so on. Radiotherapy combined with chemotherapy is the main treatment.