本文選題：縱隔腫瘤　切入點(diǎn)：神經(jīng)源性腫瘤　出處：《復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版)》2017年02期

【摘要】：目的分析縱隔原發(fā)性神經(jīng)源性腫瘤行手術(shù)治療患者的臨床特征、治療方法和預(yù)后情況。方法回顧性分析復(fù)旦大學(xué)附屬中山醫(yī)院胸外科2008年1月至2014年12月期間已行手術(shù)且病理證實(shí)為縱隔原發(fā)性神經(jīng)源性腫瘤共131例患者的臨床資料,包括臨床特征、影像學(xué)表現(xiàn)、手術(shù)方式、病理學(xué)形態(tài)和預(yù)后。結(jié)果 131例患者中男性78例(59.5%),女性53例(40.5%);有癥狀者59例(45.0%),無(wú)癥狀者72例(55.0%);腫瘤位于左后縱隔61例,右后縱隔69例,前縱隔1例。電視輔助胸腔鏡手術(shù)(video-assisted thoracic surgery,VATS)98例(74.8%),VATS輔助胸部小切口手術(shù)5例(3.8%),開(kāi)胸手術(shù)28例(21.4%)。除1例惡性神經(jīng)鞘瘤行姑息性切除外,其他均完整切除,無(wú)圍手術(shù)期死亡。病理類(lèi)型顯示良性神經(jīng)鞘瘤98例(74.8%),神經(jīng)節(jié)細(xì)胞瘤24例(18.3%),惡性神經(jīng)鞘瘤2例(1.5%),神經(jīng)纖維瘤2例(1.5%),副神經(jīng)節(jié)瘤2例(1.5%),原始神經(jīng)外胚層腫瘤(primitive neurotodermal tumour,PNET)2例(1.5%),神經(jīng)母細(xì)胞瘤1例(0.8%)。術(shù)后隨訪12~95個(gè)月,平均53個(gè)月,1例PNET因腫瘤廣泛轉(zhuǎn)移死亡,1例惡鞘姑息切除術(shù)后20天死亡,2例因其他原因死亡,其余均無(wú)瘤存活至2016年1月。結(jié)論縱隔神經(jīng)源性腫瘤多無(wú)特異性臨床癥狀,絕大部分為良性,手術(shù)切除預(yù)后良好,但惡性腫瘤則預(yù)后較差。
[Abstract]:Objective to analyze the clinical characteristics of patients with primary mediastinal neurogenic tumor undergoing surgical treatment. Methods the clinical data of 131 patients with primary mediastinal neurogenic tumor confirmed by pathology from January 2008 to December 2014 in Zhongshan Hospital affiliated to Fudan University were analyzed retrospectively. Results among 131 patients, 78 cases were male and 53 cases were female. 59 cases had symptoms, 59 cases had symptoms, 72 cases had no symptoms, 61 cases were located in left posterior mediastinum, 69 cases had right posterior mediastinum. One case of anterior mediastinum. Video-assisted thoracic Surgeryus VATSN was performed in 98 cases with vats assisted thoracic small incision operation in 5 cases and thoracotomy in 28 cases with 21. 4 position. All but 1 case underwent palliative resection of malignant neurilemmoma, and all other cases were resected completely. No perioperative death. Pathological types showed benign neurilemmoma in 98 cases, ganglioneurocytoma in 24 cases, malignant neurinoma in 2 cases, neurofibroma in 2 cases, paraganglioma in 2 cases, paraganglioma in 2 cases, primary neurotodermal tumour in 2 cases, neuroectodermal tumor in 2 cases, neurofibroma in 2 cases, primordial neuroectodermal tumor in 2 cases, primary neurotodermal tumor in 2 cases, neurofibroma in 2 cases, neuroectodermal tumor in 2 cases, neuroectodermal tumor in 2 cases. One case with neuroblastoma was followed up for 12 ~ 95 months. One case of PNET died of extensive metastasis in an average of 53 months. One case died 20 days after palliative resection of malignant sheath, 2 cases died of other causes, and the rest survived until January 2016. Conclusion mediastinal neurogenic tumors have no specific clinical symptoms. Most of the patients were benign and had a good prognosis after surgical resection, but the prognosis of malignant tumors was poor.
【作者單位】： 復(fù)旦大學(xué)附屬中山醫(yī)院胸外科;復(fù)旦大學(xué)附屬中山醫(yī)院病理科;
【基金】：國(guó)家自然科學(xué)基金(81401875)~~
【分類(lèi)號(hào)】：R734.5

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