45例儿童神经母细胞瘤临床分析

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目的总结分析45例儿童神经母细胞瘤(NB)患儿的临床特点及预后。方法 45例神经母细胞瘤患儿的临床资料,分析临床表现、临床分期及治疗情况。通过复诊、电话、信访等方式了解患儿术后预后情况。结果 45例神经母细胞瘤患者中75.0%的发病年龄在3岁以下,男女之比为2:1,肿瘤原发于肾上腺28例(62.2%),后腹膜5例(11.1%),颈部6例(13.3%),纵隔6例(13.3%),首发症状为腹部肿物者38例(84.4%),伴有腹痛30例(66.6%),腹胀20例(44.4%),胸腔积液6例(13.3%),伴有发热10例(22.2%)。就诊时远处转移12例(26.6%),其中肺转移5例(6.4%),肝转移7例(5.1%)。45例患儿中行尿香草扁桃酸VMA定量检测>30 mg/24 h者30例(78.9%),45例行血清NSE检测,>100 ng/L者41例(91.1%),29例行甲胎蛋白(AFP)定性检测,均为阴性,30例行血清乳酸脱氢酶(LDH)检测,其中>700 U/L者25例(83.3%)。生存情况:8例无瘤生存,14例带瘤生存,9例因术后放弃化疗而死亡,9例因病情恶化或者复发死亡,1年生存率:81.6%,2年生存率53.5%,5年生存率12.8%。结论神经母细胞瘤以3岁以内发病率高,男性多于女性,首发症状为腹部肿物,可伴有发热等症状,检测VMA、血液神经元特异性烯醇化酶(NSE)及LDH有助于NB的早期诊断,同时要加强医患沟通,坚持完成化疗,提高患儿生存率。 Objective To summarize the clinical features and prognosis of 45 children with neuroblastoma (NB). Methods 45 cases of neuroblastoma clinical data, analysis of clinical manifestations, clinical stage and treatment. Through referral, telephone, letters and other ways to understand the prognosis of children with postoperative. Results The incidence of 75.0% of the 45 patients with neuroblastoma was less than 3 years old at the age of 3 years. The ratio of male to female was 2: 1. The tumors were mainly located in the adrenal gland in 28 cases (62.2%), retroperitoneum in 5 cases (11.1% There were 6 cases (13.3%), 6 cases (13.3%) of mediastinum, 38 cases (84.4%) with abdominal mass, 30 cases (66.6%) with abdominal pain, 20 cases (44.4%) with abdominal distension, pleural effusion 6 cases (13.3%), accompanied by fever in 10 cases (22.2%). At the time of visit, 12 patients (26.6%) were distantly metastasized, including 5 lung metastases (6.4%) and 7 liver metastases (5.1%). Forty-five children underwent urinary vanilloid mandelic acid VMA quantitative detection> 30 mg / 24 h in 30 patients (78.9%), 45 patients with serum NSE test,> 100 ng / L in 41 patients (91.1%), 29 patients with a Serum lactate dehydrogenase (LDH) was detected in 30 cases, of which 25 cases (83.3%) were> 700 U / L. Survival: 8 patients survived without tumor, 14 patients with tumor survived, 9 patients died of chemotherapy after operation, 9 patients died of disease or relapse, the 1-year survival rate was 81.6%, the 2-year survival rate was 53.5%, 5 Annual survival rate of 12.8%. Conclusions Neuroblastoma has a high incidence of disease within 3 years of age, more men than women. The first symptom is abdominal mass, which may be associated with fever and other symptoms. VMA, blood NSE and LDH are helpful NB in ​​the early diagnosis, at the same time to strengthen communication between doctors and patients, adhere to the completion of chemotherapy, improve child survival rate.
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