Askin’s瘤相关文献复习及生存因素分析（附1例病案报道）

Review of literatures related to Askin’s tumor and analysis of survival factors (a case report)

目的讨论Askin's瘤的发病机制,临床特征,影像学表现,治疗方法及预后情况,同时明确Askin's的生存状况,旨在提高临床工作中对该疾病的认识。方法收集数据库检索1988年至2018年相关文献患者的临床和随访资料,应用Kaplan-Meier和Log-rank检验进行单因素生存分析。结果60例患者中,男44例,女16例,年龄3~65岁,肿瘤部位的分布左胸壁肿瘤21例,右胸壁肿瘤36例,纵膈1例,双侧胸壁2例。中位生存期(OS)为(12.86±1.549)个月,95%置信区间为(9.823,15.896)。通过Kaplan-Meir生存分析方法可发现年龄(P=0.048)对预后情况差异具有统计学意义,治疗方式(P=0.301),肿瘤分布部位(P=0.296),胸腔积液(P=0.485)对预后有一定的影响。结论Askin's瘤国内报道病例男性发病率高于女性,主要发病年龄为青少年,临床上通常以胸壁疼痛为首发症状,部分病例可出现罕见症状,CT常表现为软组织肿块影,Askin's瘤整体预后较差,决定预后的因素主要有年龄和治疗方式,胸腔积液的有无对预后也有一定程度的影响。随着治疗方式的改善,中位生存期较前有所提高,但仍不容乐观。

Objective To discuss the pathogenesis,clinical features,imaging manifestations,treatment methods and prognosis of Askin' s tumor, and to clarify the survival status of Askin' s tumor,in order to improve the understanding of this disease in clinical work.Methods Clinical and follow- up data of patients with relevant literatures from 1988 to 2018 were collected from the database,and kaplan-meier and log-rank tests were used for univariate survival analysis.Results Among the 60 patients,44 were male,and 16 were female,Age distribution ranged from 3 to 65 years old. There were 21 cases of left chest wall tumor at tumor site,36 cases of right chest wall tumor,1 case of mediastinum,and 2 cases of bilateral chest wall.The median survival time was (12.86±1.549) months,and the 95% confidence interval was (9.823,15.896).Kaplan-meir survival analysis showed that age (P=0.048) had a statistically significant effect on the prognosis.Treatment (P=0.301),tumor location (P=0.296) and pleural effusion (P=0.485) had a certain effect on the prognosis.Conclusion Askin' s tumor incidence of reported cases of men than women,domestic main onset age for teenagers,usually with pain in chest wall for the first symptom,some cases can appear unusual symptoms,CT is often shown as a soft tissue mass,Askin' s tumor overall prognosis is poorer,determine the prognostic factors mainly include age and treatment,prognosis of pleural effusion with corrosive has a certain degree of influence.With the improvement of treatment,the median survival was improved,but it was not optimistic.