2447例椎管内肿瘤的流行病学特点

Descriptive epidemiology of spinal cord tumors： a survey on 2 447 consecutive cases

目的 提供更多的椎管内肿瘤的流行病学知识,了解常见椎管内肿瘤的流行病学特点.方法 回顾性分析2009年1月至2013年12月5年间,在北京天坛医院脊髓脊柱病区接受手术治疗并获得组织病理学诊断的2 447例椎管内肿瘤.分析椎管内肿瘤的组织学类型与性别、肿瘤部位、发病年龄的相关性,并总结常见椎管内肿瘤的流行病学特点.结果 椎管内肿瘤2 447例,其中男1 268例,女1 179例,男∶女性别比为1.075∶1.000,脊膜瘤女性占优,女∶男=4.06∶1.00.平均年龄39.7岁.发病节段以颈段椎管最常见（35.02％）.最常见的3种椎管内肿瘤依次是神经鞘瘤782例（31.95％）、室管膜瘤445例（18.19％）、脊膜瘤248例（10.13％）.与西方国家不同,本组神经鞘瘤发病高于脊膜瘤.儿童与成人组中常见的椎管内肿瘤的组织学类型不同,最常见的儿童椎管内肿瘤（0 ～19岁）是胚胎残留组织肿瘤（畸胎瘤＋囊肿类疾病）91例（36.50％）.结论 本研究结果显示东方人群与西方人群、儿童与成人、椎管内肿瘤与颅内肿瘤具有不同的流行病学特点,反映了国内椎管内肿瘤的流行病学特点.

Objective To provide more epidemiological knowledge and understand the epidemiological characteristics for intraspinal tumors.Methods During a 5-years period,from January 2009 to December 2013,2 447 spinal cord tumors who accepted surgical treatment with clear histopathologic diagnosis in Beijing Tiantan hospital were retrospectively ananlyzed.The age,gender,tumor site and histology were studied to summarize the epidemiological characteristics of intraspinal tumors.Results Of the 2 447 patients in our study,1 268 patients were male and 1 179 were female.The overall male/female ratio was 1.075∶ 1.000.Meningiomas were more common in women,with a female to male ratio of 4.06∶ 1.00.The mean age at surgery was 39.7 years.The most common site （35.02%） of the spinal cord tumors was cervical segment.The most common spinal cord tumors were schwannoma（31.95%）,ependymoma（18.19%）,and meningioma（10.13%）.Our data indicated a higher proportion of nerve sheath cell tumors,and a lower proportion of meningiomas,compared with reports from the western countries.Compared with adult,the most common pediatric spinal cord tumor （36.50%） was embryonal residual tumors.Conclusions There was pathological diversity between pediatrics and adults,the eastern population and western population,intraspinal and intracranial tumors.The present study reflected the domestic epidemiology of intraspinal tumors.