中枢神经细胞瘤的预后及术后脑室腹腔分流率

The prognosis and rate of ventricle-peritoneal shunt of central neurocytomas

目的:探讨中枢神经细胞瘤患者手术治疗的预后及术后脑室腹腔分流率。方法:回顾分析2012年1月至2013年12月我科手术治疗并确诊的13例脑室内中枢神经细胞瘤的临床、影像、手术及病理学资料,并随访至今。结果:患者年龄14～47岁,随访47～70个月。2例术后早期分别出现丘脑梗死和脓毒症后死亡,余7例(63. 6%)全部切除,其中1例于术后18个月复发并行γ刀治疗,2例术后脑积水行脑室腹腔分流术;4例(36. 4%)次全切除,其中3例术后辅助放疗,另1例行γ刀治疗,1例于术后30个月复发再次手术切除,1例术后脑积水行脑室腹腔分流术。结论:中枢神经细胞瘤完全切除可获得良好的预后,放射治疗或γ刀是其手术后重要的治疗方式,其术后脑室腹腔分流率低于其他脑室内肿瘤。

Objective: To explore the prognosis and the rate of ventricle-peritoneal shunt(VPS) of central neurocytomas(CNs) under surgical treatment.Methods: From January 2012 to December 2013, 13 cases of CNs were diagnosed and treated in our department, and the documents of clinic, image, treatment and follow-up were collected.Results: The age of patients ranged from 14 to 47(mean was26. 2) years old and were followed up for an average time of 58 months(47-70 months). Two patients died of thalamus infarction and sepsis, respectively at acute stage post-operation. Among the remaining cases, 7 patients were performed total resection. Among the 7 cases, one got recurrence at the end of 16 months of postoperation and was treated with γ knife, and 2 cases complicated with hydrocephalus and were treated by VPS. Subtotal resection was performed in 4 patients(36. 4%), and 3cases received adjuvant radiotherapy and one case received γ knife postoperatively. Among these 4cases, one got recurrence at 30 months of postoperation and was performed tumor resection again,and another one complicated with hydrocephalus and was treated by VPS.Conclusion: Patients with CNs can achieve good prognosis with total resection, and radiotherapy or γ knife is an important postoperative treatment for CNs and postoperative rate of VPS in CNs is lower than that in other intraventricular tumors.