基底神经节区生殖细胞瘤的早期诊断及综合治疗

The early diagnosis and combined treatment with chemotherapy and radiotherapy in intracrinial basal ganglia germinoma ： report of 25 cases

目的探讨颅内基底神经节区生殖细胞瘤的早期诊断及综合治疗。方法对25例颅内基底神经节区生殖细胞瘤患者的年龄、性别、发病早期的临床症状、体征、血液中肿瘤标记物的检查及影像学检查的结果等特点进行分析判断，得出早期诊断的依据并行早期综合治疗。结果3例开颅手术，1例活检，病理证实为生殖细胞瘤，21例通过临床特点分析，在生殖细胞瘤早期即明确诊断，未行手术，直接进行化、放疗。患者随访最长7年，最短10个月，平均45个月。1例外院手术大部分切除肿瘤，病理诊断生殖细胞瘤，来我院行化、放疗，6年后肿瘤复发，再次化疗，肿瘤消失，已随访1年未见复发，其余24例随访均未见肿瘤复发。患者经过治疗后，肿瘤虽已消失，但症状、体征并不能完全缓解。结论通过细致的临床观察，综合分析判断临床特点，基底神经节区生殖细胞瘤是可以做到早期诊断，并通过化、放疗等非手术治疗达到满意的治疗效果。

Objective To study the early diagnosis and combined treatment with chemotherapy and radiotherapy in intracranial basal ganglia germinoma. Method To analyze and judge the characteristics of age, sex, early clinical symptoms, systems, serology and photocopy （ MRI, CT） of 25 patients with intracranial basal ganglia germinoma in order to get evidences of intracranial basal ganglia germinoma for early combined treatment. Results 4 cases were diagnosed as germinoma by pathology. The other 21 cases have been diagnosed early by analyzing and judging the characteristics of age, sex, early clinical symptoms, systems, serology and photocopy （MRI, CT）. All cases were treated with chemotherapy and radiotherapy. All patients were followed-up for a period from 10 months to 7 years, with the average follow-up of 45 months. The tumor recurrence was not found. Conclusions The intracranial basal ganglia germinoma can be diagnosed earlier by careful clinical observation and comprehensive analysis and judgement, and satisfied results could be realized with the chemotherapy and radiotherapy.