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目的探讨不同组织类型儿童幕下肿瘤病理特征及其临床治疗与预后,分析其预后与病理类型的相关性。方法对2002年1月至2008年1月郑州大学第一附属医院162例儿童幕下肿瘤患者临床资料、病理特征以及治疗结果进行回顾性分析。结果 162例幕下肿瘤中高级别肿瘤是低级别肿瘤的1.7倍,其中髓母细胞瘤占37.04%、星形细胞瘤占31.48%、室管膜瘤占20.99%、其他类型占10.49%。显微手术全切79.63%、次全切12.96%、大部切除7.41%;术后放疗57例、化疗23例、放疗联合化疗11例。109例获随访:2年生存率、5年生存率髓母细胞瘤为67.44%和9.30%,星形细胞瘤为率94.12%和47.06%,室管膜瘤为58.33%和12.50%。结论儿童幕下高级别肿瘤(髓母细胞瘤、星形细胞瘤、室管膜瘤)多见,其中星形细胞瘤预后优于其他类型肿瘤;显微外科手术全切是治疗首选,术后辅以放化疗可延长儿童幕下肿瘤患者生存期。
Objective To investigate the underlying tumor pathological features, clinical treatment and prognosis in children with different types of tissues and to analyze the correlation between prognosis and pathological type. Methods From January 2002 to January 2008, the clinical data, pathological features and treatment outcome of 162 cases of children under the curtain tumor in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. Results 162 cases of high-grade tumors were 1.7 times higher than those of low-grade tumors, including medulloblastoma accounting for 37.04%, astrocytoma accounting for 31.48%, ependymomas accounting for 20.99% and other types accounting for 10.49%. Microsurgical resection of 79.63%, subtotal 12.96%, mostly removed 7.41%; 57 cases of postoperative radiotherapy, chemotherapy in 23 cases, radiotherapy combined with chemotherapy in 11 cases. 109 cases were followed up: 2-year survival rate, 5-year survival rate of medulloblastoma 67.44% and 9.30%, astrocytoma 94.12% and 47.06%, ependymomas 58.33% and 12.50%. Conclusions High-grade tumors (medulloblastoma, astrocytoma and ependymoma) are common in children. The prognosis of astrocytomas is superior to other types of tumors. Microsurgery is the first choice of treatment and postoperative auxiliary Radiotherapy and chemotherapy can prolong survival of children under the curtain tumor patients.