小儿神经母细胞瘤的预后及影响因素分析

Analysis of Prognosis and Influencing Factors of Neuroblastoma in Children

目的:探讨小儿神经母细胞瘤的预后及影响因素。方法:选择昆明市儿童医院肿瘤科2014年9月-2018年6月收治的小儿神经母细胞瘤住院患儿92例作为研究对象,收集患儿临床资料,并对患儿随访2年,观察患儿预后,并分析患儿预后影响因素。结果:92例患儿中肿瘤完全切除86例,未行手术(含仅行切检)6例,口服维甲酸44例。随访2年显示,34例患儿死亡(疾病进展或复发),死亡率为36.96%(34/92);58例患儿生存,生存率为63.04%(58/92)。以是否死亡为因变量,以单因素分析中差异有统计学意义的因素为自变量进行非条件Logistic回归分析,结果显示影响患儿预后死亡的因素是原发部位(OR=3.96,P<0.05)、是否转移(OR=4.96,P<0.05)、INSS分期(OR=5.26,P<0.05)、血清NSE(OR=5.78,P<0.05)。结论:小儿神经母细胞瘤存在较高的预后不佳风险,且预后影响因素较多,应及时评估与分析,尽量完全切除肿瘤,以改善患儿预后。

Objective:To investigate the prognosis and influencing factors of neuroblastoma in children.Method:From September 2014 to June 2018,92 hospitalized children with neuroblastomas were selected from the Department of Oncology,Kunming Children’s Hospital.The clinical data of the children were collected and followed up for 2 years and the prognosis of the children and the influencing factors of the prognosis were analyzed.Result:Of the 92 children,86 cases were completely removed,6 were not operated (including only those who were examined),44 were treated with Retinoic Acid.The follow-up showed that 34 children died (disease progression or recurrence),the mortality rate was 36.96% (34/92),and 58 children survived with survival rate of 63.04% (58/92).The results showed that the factors influencing the prognosis of the children were the primary location (OR=3.96,P<0.05),whether they were transferred (OR=4.96,P<0.05),pathological type (OR=5.89,P<0.05),INS stage (OR=5.26,P<0.05),serum NSE (OR=5.78,P<0.05).Conclusion:There is a high risk of poor prognosis in children with neuroblastomas,and there are many influencing factors of prognosis.It should be evaluated and analyzed in time to completely remove the tumors in order to improve the prognosis of children.