儿童神经母细胞瘤43例临床分析

Clinical reports of 43 cases of children's neuroblastoma

目的总结本科近10年收治的儿童神经母细胞瘤(neuroblastoma,NB)患儿的临床特征及疗效。方法回顾性分析2006年11月至2016年12月收治的43例NB患儿的临床特征、治疗方法及疾病转归。结果 43例NB患儿发病年龄26天至13岁,1~5岁为发病高峰(65.1%),男:女为2.07:1,其中Ⅳ期23例(53.5%),高危30例(69.8%)。腹部包块起病多见,原发灶多位于腹膜后,骨髓为最常见转移部位。肿瘤标志物可协助诊断、监测病情。治疗主要采用化疗联合手术,自体造血干细胞移植和免疫治疗尚需积累更多经验。高危患儿总体生存率低,复发率高。结论 5岁以下幼儿出现腹部包块时,应警惕NB。NB主要采用化疗和手术治疗,自体造血干细胞移植和免疫治疗适用于高危NB。高危NB预后差,仍需研究更多治疗策略,提高生存率。

Objective To summarize the clinical features and curative effect of neuroblastoma（NB） in our department in recent 10 years. Method A retrospective analysis was conducted in 43 cases of neuroblastoma received in recent 10 years. The clinical features, treatment and disease outcomes were studied. Result Among the 43 NB cases, the age of onset was between 26 days and 13 years. The peak onset age was 1 to 5 years old（65.1%）. The rate of male versus female was 2.07：1. Among them, the number of stage Ⅳ cases was 23（53.5%）, and high-risk cases was 30（69.8%）. Abdomen mass is common at onset, and most of the original sites are located at the retroperitoneal area. Bone marrow is the most common metastasis site. Some tumor markers can assist the diagnosis and monitor the disease. Chemotherapy accompanied with surgery are main treatments. Autologous stem cell transplantation and immune therapy are still needed more experiences. The overall survival rate of high-risk NB children is still low and the recurrence rate is high. Conclusion Neuroblastoma should be considered in children with abdominal mass younger than 5 years old. Chemotherapy and surgery are main treatments in NB, and autologous stem cell transplantation and immune therapy are suitable with high-risk NB. The prognosis of high-risk NB is poor, and more treatment strategies should be studied to improve the survival rate.