中枢神经细胞瘤51例临床分析

Central neurocytoma:A clinicopathological analysis of 51 cases

目的深入认识中枢神经细胞瘤,期待提高本病的诊疗水平。方法回顾性分析总结51例中枢神经细胞瘤的临床表现,影像学检查、病理结果、预后并结合国内外文献复习。结果所有51例患者均行显微外科手术治疗,全切19例,次全切23例,部分切除9例,一般术后1个月后进行放疗,随访5个月～6a未见肿瘤复发、转移。术后患者肢体活动障碍3例,颅内感染7例,行脑室腹腔分流术1例,死亡2例,1例出现硬膜下积液,1例硬膜外血肿行开颅手术,2例出现缄默症,1例术后甲减,1例永久性双眼视明。结论中枢神经细胞瘤多于侧脑室内发现,手术风险极大,病死率与致残率较高,运用显微镜神经外科技术、术中导航等技术可有效减轻术后病死率与致残率,手术全切是治疗CNC的最佳方式,肿瘤全切预后最佳,将复发可能性将至最低。术后联合放疗,可减少复发率,化疗效果有待进一步研究。

Objective In depth understanding of central neurocytoma is expected to improve the diagnosis and treatment of this disease. Methods The clinical manifestations,imaging examination,pathological results,prognosis and literature review of 51 cases of central neurocytoma were analyzed retrospectively. Results All 51 patients underwent surgical treatment,total resection was performed in19 cases,subtotal resection in 23 cases,and partial resection in 9 cases.Radiotherapy was performed in1 month after operation.There were no tumor recurrence and metastasis in followed up period.Postoperative limb movement disorder was found in 3 cases,intracranial infection in 7 cases,ventriculoperitoneal shunt was performed in 1 case,2 cases died,subdural effusion occurred in 1 case,epidural hematoma underwent craniotomy in 1 case,mucosis occurred in 2 cases,postoperative thyroidectomy in 1 case and permanent binocular vision. Conclusion Central neurocytoma founded intraventricular that surgical risk is great,high mortality and morbidity,using microscope technique,intraoperative neurosurgery navigation technology can effectively reduce the mortality and morbidity,surgery is the best way to treat CNC cutting,tumor cut all the best prognosis,recurrence probability to a minimum.Postoperative combined radiotherapy can reduce the recurrence rate,the effect of chemotherapy needs to be further studied.