婴幼儿原发性脑肿瘤98例临床分析

Clinical Analysis of 98 Cases of Primary Brain Tumors in Children Younger than 3 Years Old

背景与目的:婴幼儿肿瘤发生率并不高,但治疗困难。本文回顾近5年我院收治3岁以下婴幼儿原发性脑肿瘤的临床特点及预后。方法:复习自2006年1月至2011年6月间上海交通大学医学院附属新华医院小儿神经外科共收治的98例婴幼儿原发性脑肿瘤患儿临床资料,所有患儿均通过外科手术将肿瘤切除,根据WHO 2007年新分类获得最终病理诊断。分析该年龄组患儿的临床症状、组织学类型、病理分级、治疗方案的特点以及影响预后的相关因素。结果:该年龄组患儿以男性多发,脑肿瘤以幕上及中线部位居多。低级别星形细胞瘤(21.4%)最为多见,之后依次为室管膜瘤(14.3%)、脉络丛乳头状瘤(12.2%)以及髓母细胞瘤(10.2%)。该年龄组患儿的临床表现特点与大龄患儿不同,以头围增大最为多见。预后与肿瘤位置、肿瘤病理、术后并发症以及手术切除程度有关。结论:该年龄组的原发性脑肿瘤患儿的病理学类型与其他年龄组差异较大,手术治疗仍为低龄患儿的首选治疗方案。

BACKGROUND OBJECTIVE： Primary brain tumors are common solid tumors in children.Management of brain tumors in children can sometimes be difficult.In this article,we explored the clinical characteristics and prognosis of child patients who had primary brain tumors and were younger than 3 years old.METHODS： Clinical data of 98 child patients with brain tumors and with an age of less than 3 years old were reviewed.Tumors in all cases were removed and diagnosed according to the 2007 WHO classification of tumors of the central nervous system.Clinical manifestations,histological type and grade,treatment strategies and other factors that may influence the prognosis were analyzed.RESULTS： Males were dominant in this group of patients.Tumors mainly located in supratentorial region or around midline.The most frequent tumor type was low-grade astrocytoma（21.4%）,followed by ependymoma（14.3%）,choroid plexus papilloma（12.2%） and medulloblastoma（10.2%）.The most common clinical presentations in this group of patients was the enlarged head circumference,which was different from those in older child patients.Prognosis was correlated with the tumor location,histological classification,extent of resection and post-operative complications.CONCLUSION： The histological types of tumors in child patients younger than 3 years old are different from those in older child patients.Neurosurgical removal is the upfront option for child patients who have primary brain tumors and younger than 3 years old.