脊髓圆锥区室管膜瘤的显微手术疗效分析

Microsurgery for patients with conical intramedullary ependymoma

目的探讨脊髓圆锥区室管膜瘤的显微手术疗效。方法回顾性分析2012年1月至2021年12月显微手术治疗的27例脊髓圆锥区室管膜瘤的临床资料。结果肿瘤全切除14例(51.9%),次全切除4例(14.8%),部分切除9例(33.3%)。术后病理均诊断为室管膜瘤(WHO分级Ⅱ级23例,Ⅲ级4例)。术后随访(40.44±28.7)个月;全切除14例中,1例术后3年复发;未全切除13例中,3例保持稳定,10例进展。末次随访,神经功能状态McCormick分级Ⅰ级14例,Ⅱ级7例,Ⅲ级2例,Ⅳ级2例,死亡2例。结论对于脊髓圆锥区室管膜瘤,早期在神经功能良好的状态下全切除肿瘤能够取得较好的疗效。如条件允许,建议行全基因组检测,结合组织学分型,能够更好地指导临床。

Objective To investigate the clinical efficacy of microsurgery for patients with conical intramedullary ependymoma(CIE).Methods The clinical data of 27 patients with CIE who underwent microsurgery from January 2012 to December 2021 were retrospectively analyzed.Results Total resection of tumors was achieved in 14 patients(51.9%),subtotal in 4(14.8%)and partial in 9(33.3%).The postoperative pathological examination showed ependymoma(23 WHO gradeⅡand 4 gradeⅢ)in all the patients.Postoperative follow-up was(40.44±28.7)months.Of 14 patients with total resection of the tumor,1 patient relapsed 3 years after surgery.Of the other 13 patients with incomplete resection of the tumor,3 remained stable and 10 progressed.At the last follow-up,McCormick gradeⅠwas achieved in 14 patients,gradeⅡin 7,gradeⅢin 2,gradeⅣin 2,and 2 patients died.Conclusions For the patients with CIE,complete resection of the tumor at an early stage with good neurological function can achieve good outcomes.If conditions permit,it is recommended to conduct whole-genome detection,which can better guide clinical practice.