小儿与成人视通路胶质瘤的临床特点

Clinical characteristics of the optic pathway gliomas in children and adult patients (analysis of 24 case)

目的探讨小儿与成人视通路胶质瘤(OPG)的临床特点。方法回顾性分析我科2003～2011年收治的24例OPG患者的临床资料。结果本组中小儿患者13例,成人11例;均有视功能损害,伴内分泌症状者分别为4例和7例。按肿瘤部位分型,OPG在小儿和成人中视神经型分别为2例和0例,视交叉型分别为9例和5例,弥散型分别为2例和6例。小儿和成人患者手术治疗分别为12例和11例;术后辅以放化疗分别为2例和6例。小儿均为低级别胶质瘤,成人中3例为高级别或浸润性胶质瘤。术后小儿OPG复发2例,成人5例;小儿患者死亡1例,成人3例。结论小儿OPG好发于视神经及视交叉,以视功能损害为主,性质偏良性,手术效果好,预后较好;成人OPG好发于视交叉及颅内弥散生长,视功能损害和内分泌症状为主,性质偏恶性,单纯手术效果较差,需辅以放、化疗,预后较差。

Objective To investigate the difference between the clinical characteristics of optic pathway gliomas（OPG） inc hildren and adult patients.Methods The clinical dada of 24 patients with OPG who were treated in our department from 2003 to 2011w ere analyzed retrospectively.Of 24 patients with OPG,13 were children and 11 adults.Results Visual dysfunction occurred in all thep atients.There was endocrine dysfunction in 4 children with OPG and 7 adults with OPG.Of 13 children with OPG,2 had optic nerveg liomas,9 optic chiasma ones and 2 diffuse type ones.Of 11 adults with OPG,5 had optic chiasma gliomas and 6 diffuse type ones.Of 8p atients with OPG receiving radiotherapy or chemotherapy after the surgery,2 were children and 6 adults.Histopathological examinations howed that all the children had low grade gliomas,8 adults low grade ones and 3 adults high grade or invasive ones.The following-upf rom 3 months to 8 years showed that the gliomas recurred in 2 children and 5 adults,and 1 patient died in the children group and 3 diedi n the adults group.Conclusions OPG occur mainly in the optic nerve and chiasma,they slant towards benign tumors and the primarys ymptom is optic dysfunction in the children with OPG,in whom the prognoses are good after the surgery.OPG occurs mainly in the opticc hiasma and slant towards diffuse growth（malignant tumors） ,and the primary symptoms include optic and endocrine dysfunction in thea dults with OPG,in whom chemotherapy and radiotherapy should be performed after the surgery and the prognoses are worse.