1022例椎管内肿瘤的流行病学分析

Epidemiological analysis on 1022 cases with intraspinal tumors

目的 分析椎管内肿瘤的流行病学特点,并与既往文献进行对比。方法 回顾性分析2015年1月—2019年12月在南京大学医学院附属鼓楼医院神经外科接受手术治疗并获得病理学诊断的1 022例椎管内肿瘤患者,分析患者年龄、性别、肿瘤部位以及组织学类型之间的相关性。结果 1 022例患者中,男507例(49.6%),女515例(50.4%),男女比例1∶1.02;接受手术治疗时平均年龄(47.19±16.98)岁。常见的七类椎管内肿瘤中,神经鞘瘤557例(54.51%),脊膜瘤145例(14.19%),脂肪瘤34例(3.33%),神经纤维瘤32例(3.13%),海绵状血管瘤32例(3.13%),室管膜瘤31例(3.03%)和星形细胞瘤29例(2.84%);男女比例分别为神经鞘瘤1.15,脊膜瘤0.21,脂肪瘤0.89,神经纤维瘤2.56,海绵状血管瘤1.67,室管膜瘤1.07和星形细胞瘤2.63。结论 既往国内外报道椎管内肿瘤男性较女性多发不同,本研究发现椎管内肿瘤发病总体无明显性别差异,但脊膜瘤女性占明显优势。与西方人群中脊膜瘤占优势不同,本研究结果显示前四位最常见的椎管内肿瘤类型依次为神经鞘瘤、脊膜瘤、脂肪瘤和神经纤维瘤。本研究的临床数据反映了国内椎管内肿瘤的流行病学特点。

Objective To analyze the epidemiological characteristics of intraspinal tumors and compared with previous literature. Methods 1 022 patients with intraspinal tumors who received surgical treatment and pathological diagnosis in the Department of Neurosurgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2015 to December 2019 were analyzed retrospectively, and the correlation between the patient’s age, gender, tumor location and histological type was analyzed. Results Of the 1 022 patients, 507(49.6%) were males and 515(50.4%) were females(male/female ratio 1∶1.02). The mean age at surgery was(47.19±16.98) years old. Among the seven types of common intraspinal tumors, 557(54.51%) were neurinomas, 145(14.19%) were meningiomas, 34(3.33%) were lipomas, 32(3.13%) were neurofibromas, 32(3.13%) were cavernous hemangiomas, 31(3.03%) were ependymomas and 29(2.84%) were astrocytomas. The male to female ratio was 1.15 for schwannoma, 0.21 for meningioma, 0.89 for lipoma, 2.56 for neurofibroma, 1.67 for cavernous hemangioma, 1.07 for ependymoma and 2.63 for astrocytoma. Conclusions It has been reported in the past that the incidence of intraspinal tumors in men is different from that in women. This study found that there was no significant gender difference in the incidence of intraspinal tumors, but women with meningioma had a significant advantage. Different from the predominance of meningioma in the western population, the results of this study show that the first four most common types of intraspinal tumors are schwannoma, meningioma, lipoma and neurofibroma in turn. The clinical data of this study reflect the epidemiological characteristics of intraspinal tumors in China.