嗅神经母细胞瘤7例诊疗分析

Analysis of diagnosis and treatment of 7 cases with Olfactory neuroblastoma

目的:探讨嗅神经母细胞瘤的临床特点及诊断治疗方法,提高本病的诊疗水平。方法:回顾分析我科1993年4月-2010年10月收治经手术和病理证实的7例嗅神经母细胞瘤的临床资料,综合文献,对其临床表现、诊断和治疗进行探讨。7例中A期1例,B期4例,C期2例。结果:本组单纯放疗1例,手术+术后放疗4例,手术+术后放疗+化疗2例;本组病例1、3、5年生存率分别为100%,71.43%,57.14%。随访中发现颈部淋巴结转移由初次确诊的14.28%上升至42.85%。结论:嗅神经母细胞瘤的预后与Kadish分期、病理分化程度、治疗方式有关,病变位于鼻腔顶部且前颅窝骨质破坏提示本病的可能,早期诊断,手术+放疗等的综合治疗,能提高本病的生存率,晚期患者的辅助化疗是必要的。

Objective：To discuss the clinical characteristics, diagnosis and treatment of Olfactory neuroblastoma （ONB） ,To improve the diagnosis and treatment level of ONB. Methods： The clinical data of 7 patients suffering from ONB since 1993 to 2010 were analyzed retrospectively, and its clinical characteristics, diagnosis and treatment were discussed in combination with review of literatures. 1 case was stage A,4 cases stage B,2 cases stage C. Re- suits： Of all the 7 cases, one case was treated by radiotherapy alone, four were treated with surgery combined with ra- diotherapy , and two were treated with surgery combined with radiotherapy and chemotherapy. The 1 - ,3 - and 5 - year survival rates were 100% ,71.43% ,57.14%. Conclusion： The prognosis of ONB is associated with the clinical stage and treatment modalities. Focuses located at the top of the nose cavity and bone destruction in anterior skull base both indicate the possibility of ONB. The key to improve the survival rate of the disease is early accurate diagno- sis and combined treatment, and chemotherapy contributed to the prevention of distance metastasis.