8例新生儿神经母细胞瘤临床特点及预后分析

Clinical features and prognosis of eight neuroblastomas in neonates

目的：提高对新生儿神经母细胞瘤临床特征及预后的认识.方法：对2010年7月至2015年3月中国医科大学附属第四医院儿科收治的8例新生儿神经母细胞瘤患儿的临床表现、组织病理分型、治疗及预后进行回顾性分析.结果：患儿中男性5例,女性3例,发病年龄孕24周至生后28天,中位数年龄9天.原发肿瘤4例位于左肾上腺,2例位于右肾上腺,1例位于双肾上腺,1例位于盆腔.6例经肿瘤组织病理学确诊,2例经骨髓细胞学确诊.临床分期：1期1例,2期1例,4S期6例.5例给予原发肿瘤切除和术后化疗,1例给予一侧原发肿瘤切除和术后化疗,2例仅给予化疗.8例均生存,随访时间6-56个月,6例均达持续完全缓解,2例带瘤生存.结论：新生儿神经母细胞瘤具有自身生物学特性,临床分期主要为1期、2期和4S期,病理分型多数是神经母细胞瘤,预后良好。

Objective：To investigate the clinical features and prognosis of neuroblastoma in neonates. Methods：Clinical data of eight patients with neonatal neuroblastoma who were admitted to the Fourth Affiliated Hospital of China Medical University between July 2010 and March 2015 were retrospectively analyzed. Results：The patients included five males and three females with a median age of 9 days. The primary site of the tumors was as follows：left adrenal gland in four cases, right adrenal gland in two cases, bilateral adrenal glands in one case, and pelvic cavity in one case. Six of the eight patients were finally diagnosed via tumor histopathology, and the other two patients were diagnosed by bone marrow cytology. The clinical staging results were obtained as follows：stage 1 in one of the eight patients, stage 2 in another patient, and stage 4S in the remaining six patients. Primary tumor resection and postoperative che-motherapy were conducted in five patients. Unilateral resection of the primary tumor and postoperative chemotherapy were performed in one of the patients, and a simple chemotherapy of the tumor was conducted in the other two patients. All eight patients survived, with a follow-up of 6 to 56 months. Continued complete remission was achieved by six patients, and survival with tumor was achieved in the other two patients. Conclusion： Neonatal neuroblastoma has its own biological characteristics. The main clinical stages of the tumor are stage 1, 2, and 4S. The majority of pathological typing is neuroblastoma, and the prognosis is favorable.