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目的探讨儿童及青少年纵隔肿瘤的发病特点、病理类型与发生部位及发病年龄的关系,并评价其诊治手段及预后因素。方法选取1991年1月-2006年12月在中山大学肿瘤防治中心治疗并确诊的儿童及青少年纵隔肿瘤85例,并对其临床及随访资料进行回顾性分析。采用SPSS13.0统计软件分析,计数变量的比较采用χ2检验,生存率计算用寿命表法。采用Kaplan-Meier进行生存分析,Cox模型进行多因素生存分析。结果不同病理类型的纵隔肿瘤与发病部位有一定关系(P=0.001),不同病理类型的纵隔肿瘤与发病年龄也有一定关系(P=0.010)。85例纵隔肿瘤中,良性肿瘤37例均生存,48例恶性肿瘤患儿总的5 a生存率为52%(25/48例)。单因素生存分析显示,影响总生存时间的危险因素:不同辅助治疗方式(P=0.061,0.001)、肿瘤部位(P=0.046)。Cox回归分析显示,辅助治疗方式为独立预后因素(P=0.010)。结论 X线及CT是纵隔肿瘤诊断的主要方法。不同病理类型的纵隔肿瘤与发病部位及发病年龄均有一定关系。辅助治疗方式、肿瘤部位均影响患儿总生存时间。
Objective To investigate the characteristics of mediastinal tumor in children and adolescents, the relationship between the pathological type, the site of occurrence and the age of onset, and to evaluate the diagnosis and treatment and the prognostic factors. Methods From January 1991 to December 2006 in Zhongshan University Cancer Center for the treatment and diagnosis of 85 cases of mediastinal tumors in children and adolescents, and its clinical and follow-up data were retrospectively analyzed. Using SPSS13.0 statistical software analysis, count variables were compared using χ2 test, survival rate was calculated using life table method. Kaplan-Meier survival analysis, Cox model for multivariate survival analysis. Results The mediastinal tumor with different pathological types had a certain relationship with the site of disease (P = 0.001). The mediastinal tumors with different pathological types also had a certain relationship with the age of onset (P = 0.010). In 85 cases of mediastinal tumors, benign tumors in 37 cases were alive, 48 cases of malignant tumors in children 5-year survival rate was 52% (25/48 cases). Univariate survival analysis showed that the risk factors affecting the overall survival time were different adjuvant treatments (P = 0.061, 0.001) and tumor sites (P = 0.046). Cox regression analysis showed that adjuvant therapy was an independent prognostic factor (P = 0.010). Conclusion X-ray and CT are the main methods of diagnosis of mediastinal tumors. Different pathological types of mediastinal tumor and the incidence of disease and age have a certain relationship. Adjuvant therapy, tumor sites affect the overall survival of children.