儿童纵隔肿瘤85例

Mediastinal Tumors in 85 Children

目的探讨儿童及青少年纵隔肿瘤的发病特点、病理类型与发生部位及发病年龄的关系,并评价其诊治手段及预后因素。方法选取1991年1月-2006年12月在中山大学肿瘤防治中心治疗并确诊的儿童及青少年纵隔肿瘤85例,并对其临床及随访资料进行回顾性分析。采用SPSS13.0统计软件分析,计数变量的比较采用χ2检验,生存率计算用寿命表法。采用Kaplan-Meier进行生存分析,Cox模型进行多因素生存分析。结果不同病理类型的纵隔肿瘤与发病部位有一定关系(P=0.001),不同病理类型的纵隔肿瘤与发病年龄也有一定关系(P=0.010)。85例纵隔肿瘤中,良性肿瘤37例均生存,48例恶性肿瘤患儿总的5 a生存率为52%(25/48例)。单因素生存分析显示,影响总生存时间的危险因素:不同辅助治疗方式(P=0.061,0.001)、肿瘤部位(P=0.046)。Cox回归分析显示,辅助治疗方式为独立预后因素(P=0.010)。结论 X线及CT是纵隔肿瘤诊断的主要方法。不同病理类型的纵隔肿瘤与发病部位及发病年龄均有一定关系。辅助治疗方式、肿瘤部位均影响患儿总生存时间。

Objective To explore the clinical characteristics of children and adolescents diagnosed as mediastinal tumors,and the relations between pathological characteristics and the tumor position,between pathological characteristics and clinical age.To discuss diagnostic measures as well as treatment and to evaluate the diagnosis,treatment and prognostic factors. Methods A total of 85 children and adolescents diagnosed as mediastinal tumors and treated in Sun Yat-Sen University from Jan.1991 to Dec.2006 were selected and retrospectively analyzed.Statistical data were analyzed with SPSS 13.0 software.Qualitative data were analyzed by Chi-square test and survival rate was calculated by life table method.Kaplan-Meier method was performed to evaluate the prognostic factors in univariant analysis.The independent prognostic factors were screened with Cox regression model. Results Specific relations were found between pathological characteristics and position of mediastinal tumors（P=0.001）,and age of onset（P=0.010）.Among 85 cases,37 patients with benign tumor all survived.The 5-year survival rate of the 48 patients with malignant tumor was 52%（25/48 cases）.Univariate analysis indicated the prognostic factors of malignant mediastinal tumors were：adjuvant therapy（P=0.061,0.001）,and tumor site（P=0.046）.Cox regression model indicated the independent prognostic factors were adjuvant therapy（P=0.010）. Conclusions X-ray and CT scanning are major options for diagnosis.There are specific relations between pathological characteristics and the position of mediastinal tumors,and age of onset.Adjuvant therapy and tumor site are prognostic factors in malignant mediastinal tumors.