毛细胞型星形细胞瘤的诊断和治疗

Diagnosis and Treatment of Pilocytic Astrocytoma

目的探讨毛细胞型星形细胞瘤发病特点、病理学和影像学表现以及治疗方法。方法回顾性分析我院近3年来经手术病理证实的19例毛细胞型星形细胞瘤的临床资料、手术和随访结果。结果本组15例发病年龄在1．5～19岁，占全部病例的78．9％，部位以小脑多见（63％）。临床表现以颅内压增高为主、其次为共济失调。影像学CT和MRI多表现为囊性伴壁结节型（52％），确诊主要依靠病理学。肿瘤全切除13例，次全切除5例，大部分切除1例。术后早期症状明显改善16例，2例出现神经功能缺失，无死亡病例。结论毛细胞型星形细胞瘤多见于20岁以下青少年，属良性胶质瘤；显微手术全切处肿瘤可取得良好效果。

Objective To explore the clinical, pathological, radiological characteristics and surgical experience of pilocytic astrocytoma. Methods 19 cases of pilocytic astrocytoma that were treated at our hospital between 2003 and 2006 are presented. The clinical finding, radiological and histological characteristic of pilocytic astrocytoma and surgical experience to these tumors were reviewed. Result Of the 19 cases whom suffer from pilocytic astrocytoma, 15 patients＇s age was 1.5-19 years old（78.9%）, and the most tumor location was in cerebellum（63%）. The most common presenting symptom was increased intracranial pressure, and ataxia. The main manifestations on CT and MRI were cystic tumor with a mural nodule（52 %）. Final diagnosis was made depending on mainly pathology. Total tumors removal was achieved in 13 cases, subtotal resection in 5 cases, partial resection in l patient. Early symptoms improved significantly after operation in 16 cases, neurological deficits in two cases, and no operative mortality. Conclusion pilocytic astrocytoma that is prevalent in young people under the age of 20, is a benign glioma, and microsurgical resection of tumors can achieve a good outcome.