Cell transplantation for the treatment of spinal cord injury–bone marrow stromal cells and choroid plexus epithelial cells

Transplantation of bone marrow stromal cells （BMSCs） enhanced the outgrowth of regenerating axons and promoted locomotor improvements of rats with spinal cord injury （SCI）. BMSCs did not survive long-term, disappearing from the spinal cord within 2-3 weeks after transplantation. Astrocyte-devoid areas, in which no astrocytes or oligodendrocytes were found, formed at the epicenter of the lesion. It was remarkable that numerous regenerating axons extended through such astrocyte-devoid areas. Regenerating axons were associated with Schwann cells embedded in extracellular matrices. Transplantation of choroid plexus epithelial cells （CPECs） also enhanced axonal regeneration and locomotor improvements in rats with SCI. Although CPECs disappeared from the spinal cord shortly after transplantation, an extensive outgrowth of regenerating axons occurred through astrocyte-devoid areas, as in the case of BMSC transplantation. These findings suggest that BMSCs and CPECs secret neurotrophic factors that promote tissue repair of the spinal cord, including axonal regeneration and reduced cavity formation. This means that transplantation of BMSCs and CPECs promotes ＂intrinsic＂ ability of the spinal cord to regenerate. The treatment to stimu- late the intrinsic regeneration ability of the spinal cord is the safest method of clinical application for SCI. It should be emphasized that the generally anticipated long-term survival, proliferation and differentiation of transplanted cells are not necessarily desirable from the clinical point of view of safety.

Release of interleukin-10 and neurotrophic factors in the choroid plexus：possible inductors of neurogenesis following copolymer-1 immunization after cerebral ischemia

Copolymer-1（Cop-1） is a peptide with immunomodulatory properties, approved by the Food and Drug Administration of United States in the treatment of multiple sclerosis. Cop-1 has been shown to exert neuroprotective effects and induce neurogenesis in cerebral ischemia models. Nevertheless, the mechanism involved in the neurogenic action of this compound remains unknown. The choroid plexus（CP） is a network of cells that constitute the interphase between the immune and central nervous systems, with the ability to mediate neurogenesis through the release of cytokines and growth factors. Therefore, the CP could play a role in Cop-1-induced neurogenesis. In order to determine the participation of the CP in the induction of neurogenesis after Cop-1 immunization, we evaluated the gene expression of various growth factors（brain-derived neurotrophic factor, insulin-like growth factor 1, neurotrophin-3） and cytokines（tumor necrosis factor alpha, interferon-gamma, interleukin-4（IL-4）, IL-10 and IL-17）, in the CP at 14 days after ischemia. Furthermore, we analyzed the correlation between the expression of these genes and neurogenesis. Our results showed that Cop-1 was capable of stimulating an upregulation in the expression of the genes encoding for brain-derived neurotrophic factor, insulin-like growth factor 1, neurotrophin-3 and IL-10 in the CP, which correlated with an increase in neurogenesis in the subventricular and subgranular zone. As well, we observed a downregulation of IL-17 gene expression. This study demonstrates the effect of Cop-1 on the expression of growth factors and IL-10 in the CP, in the same way, presents a possible mechanism involved in the neurogenic effect of Cop-1.

The choroid plexus-cerebrospinal fluid interface in Alzheimer's disease:more than just a barrier

The choroid plexus is a complex structure which hangs inside the ventricles of the brain and consists mainly of choroid plexus epithelial（CPE） cells surrounding fenestrated capillaries.These CPE cells not only form an anatomical barrier,called the blood-cerebrospinal fluid barrier（BCSFB）,but also present an active interface between blood and cerebrospinal fluid（CSF）.CPE cells perform indispensable functions for the development,maintenance and functioning of the brain.Indeed,the primary role of the choroid plexus in the brain is to maintain homeostasis by secreting CSF which contains different molecules,such as nutrients,neurotrophins,and growth factors,as well as by clearing toxic and undesirable molecules from CSF.The choroid plexus also acts as a selective entry gate for leukocytes into the brain.Recent findings have revealed distinct changes in CPE cells that are associated with aging and Alzheimer＇s disease.In this review,we review some recent findings that highlight the importance of the CPE-CSF system in Alzheimer＇s disease and we summarize the recent advances in the regeneration of brain tissue through use of CPE cells as a new therapeutic strategy.

The expressions of brain-derived neurotrophic factor and nerve growth factor in purified rat choroid plexus epithelial cells in vitro

Objective： To detect the expressions of brain-derived neurotrophic factor （BDNF） and nerve growth factor （NGF） in purified rat choroid plexus epithelial cells in vitro. Methods： Primary and passage choroid plexus epithelial cells were obtained from newborn, one-day Spragne-Dawley rats. The expressions of BDNF and NGF were measured by qRT-PCR and Western blottingting. The secretions of BDNF and NGF were detected by ELISA. Cell supematants of primary cells, purified cells and passage 1 cells were harvested. Results： The expression of BDNF in the purified cells was significantly lower than that in the primary cells （P〈0.05）, and it in the primary cells and the purified cells was significantly higher than that in the passage 1 cells （P〈0.05）. The expression of NGF was significantly higher in the purified cells than in the primary cells and the passage 1 cells （P〈0.05）. It in the passage 1 cells was significantly higher than that in the primary cells （P〈0.05）. Conclusion： The time of CPECs transplantation for central nervous system diseases should be selected based on their secretory function and features,which could lead to better and more effective treatment.

Neural differentiation of choroid plexus epithelial cells:role of human traumatic cerebrospinal fluid

As the key producer of cerebrospinal fluid（CSF）,the choroid plexus（CP） provides a unique protective system in the central nervous system.CSF components are not invariable and they can change based on the pathological conditions of the central nervous system.The purpose of the present study was to assess the effects of non-traumatic and traumatic CSF on the differentiation of multipotent stem-like cells of CP into the neural and/or glial cells.CP epithelial cells were isolated from adult male rats and treated with human non-traumatic and traumatic CSF.Alterations in m RNA expression of Nestin and microtubule-associated protein（MAP2）,as the specific markers of neurogenesis,and astrocyte marker glial fibrillary acidic protein（GFAP） in cultured CP epithelial cells were evaluated using quantitative real-time PCR.The data revealed that treatment with CSF（non-traumatic and traumatic） led to increase in m RNA expression levels of MAP2 and GFAP.Moreover,the expression of Nestin decreased in CP epithelial cells treated with non-traumatic CSF,while treatment with traumatic CSF significantly increased its m RNA level compared to the cells cultured only in DMEM/F12 as control.It seems that CP epithelial cells contain multipotent stem-like cells which are inducible under pathological conditions including exposure to traumatic CSF because of its compositions.

Choroid Plexus Carcinoma: A Rare Tumor in Adult

Background: Choroid plexus carcinoma is a highly aggressive malignant, infrequent tumor with poor prognosis. About 80% of choroid plexus carcinoma occurs in children, but it is uncommon in adults. Because of the rarity of the choroid plexus carcinoma, there is no established treatment protocol for this malignancy. Case Description: A 21-year-old man with past medical history of asthma presented to us with the chief complaint of morning headache for one month. His brain magnetic resonance imaging (MRI) showed a mass in the trigone and occipital horn of the left lateral ventricle. He had undergone a left occipitoparietal craniotomy, posterior interhemispheric precuneus approach with grossly total removal of the tumor. The histology examination of the tumor proved to be choroid plexus carcinoma. This patient achieved a favorable outcome after having a grossly complete surgical resection followed by postoperative adjuvant radiotherapy and chemotherapy. Conclusions: Choroid plexus carcinoma is aggressive and is associated with dismal prognosis. The 5-year survival rates for choroid plexus carcinoma vary between 10% and 50%. Currently, there is no established treatment protocol for choroid plexus carcinoma. Complete resection of this malignant tumor is the primary goal of treatment since it allows best chance of survival and improves the overall prognosis.

Transplanted choroidal plexus epithelial cells can integrate with organotypic spinal cord slices into a new system

This study aimed to evaluate the integration of transplanted choroidal plexus epithelial cells with organotypic spinal cord slices.Organotypic spinal cord slices,normally cultured for 6 days,were divided into control group(Ctrl)and transplanted group(T).The choroidal plexus epithelial cells were dissociated and primary cultured(C group).The choroidal plexus epithelial cells cultured for 6–7 days were labeled by 1,1’-dioctadecyl-3,3,3’,3’-tetramethylindocarbocyanineperchlorate(CM-Dil),and were identified by transthyretin(TTR)in immunocytochemistry.They were adjusted to the density of 0.5–1×107/ml,then 2μl cells suspension were transplanted to the spinal cord slices in the T group.The same amount of basal medium was dripped on the spinal cord slices in the Ctrl group.After 14 days of transplantation,the differentiations into neurons and astrocytes,and the synapses were identified by immunofluorescence histochemistry.At the same time,the ratios of cell differentiations and synapses in new system,and the changes of MAPK signaling pathway were tested by western blotting.The choroid plexus epithelial cells were well labeled by CM-Dil and were immune-stained by TTR in immunocytochemistry.The choroid plexus epithelial cells bodies were small when transplanted on the spinal cord slices,but big when transplanted on the polyester membrane inserts.The transplanted cells could differentiate into astrocytes,and possibly differentiate into neurons,and there were a large number of synaptophysin positive vesicles between transplanted cells and organotypic spinal cord slices in immunofluorescence histochemistry.The levels of GFAP,TUB-III and synaptophysin in the T group were higher than which in the Ctrl and C groups in western blotting(P<0.05).And the ratios of p-JNK/JNK and p-P38/P38 in the T group were significantly lower than which in the Ctrl and C groups(P<0.05).But the ratio of p-ERK/ERK in the three groups was of no significant difference.The transplanted choroidal plexus epithelial cells can integrate with organotypic spinal cord slices into a new system.

Choroid Plexus Papilloma of the Fourth Ventricle Developing Postoperative Intracranial and Rectal Hemorrhage Three Times： A Case Report

Introduction Choroid plexus papilloma （CPP） is a relatively rare, slow-growing benign tumor （WHO level I）. Recently, an adult patient with fourth ventricle choroid plexus papilloma received surgery via a suboc- cipital midline approach in our hospital. It has been rare in clinical practice to see postoperative hemorrhage occurring in the same patient 3 times. The causes of the hemorrhage were analyzed based on literature regarding postoperative hemorrhage in choroid plexus papilloma and in intracranial tumors. The case involved in our study is described and detailed in the following.

Endoscopic Third Ventriculostomy with or without Choroid Plexus Coagulation for Treatment of Hydrocephalus in Guinea: Analysis of 76 Cases in the Department of Neurosurgery of Kipe, Conakry

In low-income countries, endoscopic third ventriculostomy (ETV) with or without choroid plexus coagulation (CPC) is an increasingly accepted alternative to shunt therapy in adult and pediatric hydrocephalus. The authors report the result of this treatment in Conakry in a mixed population of adult and pediatric patients regardless of the etiology of the hydrocephalus. A retrospective study was conducted on 76 patients undergoing 89 ETV from January 2013 to September 2020. The predominant group of patients was infants less than one year with a mean age of 4.3 months and extremes of 1 - 8 months. The H/F sex ratio was 1.7/1. All patients presented acutely with signs of high intracranial pressure. Post-infectious causes and malformations and tumors were the main etiologies, respectively 21%, 47.3%, and 15.7%. The mean duration of the endoscopic procedures was 49.93 ± 10.9 mm, associated with a choroid plexus coagulation in 42% of cases. The complication rate in the first month was 22%, with CSF leak (5%) and death (11%) accounting for the majority. At three months, the complications rates were 45%, with 14.4% closed stroma, 6% epilepsy, and 24% mortality. The mean follow-up was 28 months (range 2 - 53), and the global success rate of 61%. Our study, with its limitations, shows that ETV with CPC is a safe primary approach for the treatment of hydrocephalus in low-income countries regardless of the etiology and the age of the patients.

High Blood Pressure Effects on the Brain Barriers and Choroid Plexus Secretion

High blood pressure produces ventricular dilation, variations in circumventricular organs and changes in the cerebrospinal fluid compositions. On the other hand, chronic hypertension in spontaneously hypertensive rats can cause changes in the integrity of the brain barriers: blood-cerebrospinal fluid barrier and blood brain barrier. The permeability of the brain barriers can be studied by using transthyretin and S-100β. In the present work we study the integrity of the brain barrier and the choroid plexus function variations in arterial hypertension. Control rats and spontaneously hypertensive rats were used and the choroid plexus were processed by immunohistochemistry with anti-transthyretin and anti-vasopressin. Western blot was also performed in cerebrospinal fluid, serum and choroid plexus using anti-S-100β, anti-transthyretin. The accumulation of transthyretin immunoreactive was bigger in spontaneously hypertensive rats with respect to the control. Vasopressin was also higher in spontaneously hypertensive rats with respect to the control. Western blot showed that transthyretin tetramer was higher in the spontaneously hypertensive rats than in the control rats. The expression of transthyretin monomer was lower in hypertensive rats than the control in the cerebrospinal fluid, the transthyretin monomer reaction in the blood was stronger in hypertensive than in control rats. Western blot for the S-100 β showed an increase in blood and cerebrospinal fluid of hypertensive rats. The high blood pressure produces a disruption of the blood brain barrier and blood to cerebrospinal fluid barrier that allows extravasations from the cerebrospinal fluid to the blood and from the blood to the cerebrospinal fluid.

Clinical analysis of four cases of intracranial choroid plexus cysts

Objective To summarize and report the diagnosis and management of choroid plexus cysts. Methods The clinical data of 4 choroid plexus cysts cases from March 2005 and 2010 March were analyzed retrospectively,and pathology appearances,surgical treatment were evaluated. Results Intracranial cystic lesion

无创产前检测技术在胎儿脉络丛囊肿筛查染色体异常的应用

目的探讨无创产前检测技术(NIPT)应用于胎儿脉络丛囊肿(CPC)筛查染色体异常的临床价值。方法回顾性分析因胎儿CPC或CPC合并其他超声软指标异常孕妇选择NIPT的临床资料,总结NIPT的检出率、阳性预测值等指标。结果608例胎儿CPC或CPC合并其他超声软指标异常孕妇中,16例胎儿为高风险,检出率为2.6%(16/608),9例为染色体非整倍体,7例为染色体拷贝数变异(CNV)。15例孕妇选择了浸入性产前诊断,确诊8例,阳性预测值(PPV)为53.3%(8/15)。≥35岁和<35岁的胎儿CPC检出率差异无统计学意义(χ^(2)=0.000,P=1.000)。iCPC和cCPC的检出率差异有统计学意义(χ^(2)=8.988,P=0.003)。双侧、左侧和右侧胎儿CPC的检出率差异无统计学意义(P>0.05)。结论CPC与胎儿染色体异常存在相关性。NIPT可应用于超声提示胎儿CPC孕妇的可选筛查技术,且筛查准确性较高,避免侵入性检查,有助于提高产前诊断的检出率,降低产前诊断压力。

Mechanism of Cu entry into the brain:many unanswered questions

Brain tissue requires high amounts of copper(Cu)for its key physiological processes,such as energy production,neurotransmitter synthesis,maturation of neuropeptides,myelination,synaptic plasticity,and radical scavenging.The requirements for Cu in the brain vary depending on specific brain regions,cell types,organism age,and nutritional status.Cu imbalances cause or contribute to several life-threatening neurologic disorders including Menkes disease,Wilson disease,Alzheimer’s disease,Parkinson’s disease,and others.Despite the well-established role of Cu homeostasis in brain development and function,the mechanisms that govern Cu delivery to the brain are not well defined.This review summarizes available information on Cu transfer through the brain barriers and discusses issues that require further research.

健康成年人脉络丛体积在自然衰老中的改变

目的研究健康成年人脉络丛(choroid plexus,CP)体积与年龄、性别的相关变化规律以及与其他脑区体积的关联,探讨脉络丛体积(choroid plexus volume,CPV)变化与大脑退行性改变的关系。方法2023年8月至2024年2月于陆军军医大学第一附属医院健康体检中心招募320例18~85岁健康受试者,通过简单随机抽样将受试者随机分为2组:7.0T组和3.0T组(每组各160例),分别进行3.0T和7.0T磁共振成像(magnetic resonance imaging,MRI)的矢状位三维结构MPRAGE序列扫描,使用FreeSurfer 6.0软件获得CP及其他脑区的体积,Spearman相关性分析CPV与年龄的相关性。独立样本t检验分析不同性别之间CPV的差异;偏相关分析CPV与其他脑区体积的相关性。结果共纳入311例受试者。3.0T和7.0T MRI扫描结果均显示,CPV与年龄呈正相关(3.0T:r=0.462,P<0.001;7.0T:r=0.539,P<0.001);男性的CPV均显著大于女性[3.0T:(1.40±0.47)vs(1.08±0.39)mL,P<0.001;7.0T:(2.43±0.68)vs(1.98±0.38)mL,P<0.001]。此外,3.0T MRI结果显示,CPV与白质高信号、脑脊液的体积呈正相关(P<0.001),与全脑灰质、全脑白质、海马、丘脑等体积呈负相关(P<0.05)。结论CPV随年龄的增长而增加,且存在性别差异,不受场强及分辨率限制。CPV与白质高信号、海马等脑区结构具有相关性,提示CPV增大参与大脑退行性改变的过程。CPV变化可作为大脑退行性改变的新影像标志物。

儿童脉络丛肿瘤影像特点回顾分析

目的旨在对小儿脉络丛乳头状瘤(CPT)的影像特征进行分析,对该病的影像学及临床特点进行总结,加深对该病的了解,提高诊断符合率。方法回顾分析2016年8月至2023年1月于本院收治的16例儿童CPT的影像资料,所有病例均行CT及磁共振成像(MRI)。结果病灶位于左侧脑室9例,右侧脑室3例,三脑室3例;双侧脑室1例,患儿发病年龄区间为2个月至6岁。病理证实10例脉络丛乳头瘤、1例不典型脉络丛乳头状瘤(ACPP)、5例脉络丛癌。CT呈微高密度影,2/16(12.%)内见点状钙化灶;MRI中,T_(1)WI主要为等信号,T_(2)WI、液体衰减反转恢复序列(FLAIR)信号稍高,可囊性、坏死和病灶内出血,实性部分DWI高信号,并信号欠均,增强后明显不均匀强化。脉络丛乳头状瘤(CPP)周围组织分界清晰;ACPP、脉络丛症(CPC)与周围分界欠清,瘤周可见水肿;ADC值低,代表恶性程度大。结论小儿CPT具有相应的临床表现及影像学特点,CT、MRI检查显示病灶的形态、位置、大小、边界、钙化、囊变、强化特点、与周围组织关系、是否伴有脑积水等有助于诊断及鉴别诊断,提高术前诊断水平。

Choroid plexus CCL2‒CCR2 signaling orchestrates macrophage recruitment and cerebrospinal fluid hypersecretion in hydrocephalus

The choroid plexus(ChP)serves as the principal origin of cerebrospinal fluid(CSF).CSF hypersecretion due to ChP inflammation has emerged as an important pathogenesis of hydrocephalus recently.Nevertheless,the precise mechanisms of ChP inflammation and the ensuing CSF hypersecretion in hydrocephalus remain ill-defined.In the present study,we elucidate the critical role of macrophages in the pathogenesis of ChP inflammation.Specifically,we identify the chemokine CCL2,released by ChP epithelial cells,recruits CCR2+monocytes to the ChP thereby inciting hydrocephalus pathogenesis.The accumulated ChP macrophages increase the inflammation in ChP epithelial cells through TNF-α/TNFR1/NF-κB signaling cascade,thereby leading to CSF hypersecretion.Strikingly,augmentation of ChP‒CCL2 using an adeno-associated viral approach(AAV)exacerbates macrophage recruitment,activation,and ventriculomegaly in rat PHH models.Systemic application of Bindarit,a specific CCL2 inhibitor,significantly inhibits ChP macrophage infiltration and activation and reduces CSF secretion rate.Furthermore,the administration of CCR2 antagonist(INCB 3284)reduces ChP macrophage accumulation and ventriculomegaly.This study not only unveils the ChP CCL2‒CCR2 signaling in the pathophysiology of hydrocephalus but also unveils Bindarit as a promising therapeutic choice for the management of posthemorrhagic hydrocephalus.

脉络丛及其与衰老相关疾病的关系

脉络丛由位于基底层上的上皮细胞组成,相邻脉络丛上皮细胞之间的紧密连接形成了血脑脊液屏障,它与血脑屏障一起对大脑微环境的稳态至关重要。脉络丛上皮可向脑室分泌脑脊液、生长因子、神经肽和脂类物质,同时脉络丛也是免疫细胞进入大脑的门户。衰老和神经退行性疾病的病理生理学仍然还存在大量未知,越来越多的研究将脉络丛与这些年龄相关性疾病的病因关联起来。本文综述了目前已知的脉络丛上皮与年龄相关疾病之间的关系,以期为防治相关疾病提供新的线索。

超声软指标胎儿脉络丛囊肿对胎儿染色体异常的预测价值

目的:探讨超声软指标胎儿脉络丛囊肿对胎儿染色体异常的预测价值.方法:选取2020年8月至2022年8月于本院就诊的214例产前胎儿超声软指标异常孕妇作为研究对象.统计不同超声软指标异常胎儿染色体异常情况,以及超声软指标脉络丛囊肿胎儿临床资料,使用Spearman秩相关性分析方法分析超声软指标脉络丛左、右侧囊肿直径与胎儿染色体异常相关性,使用受试者工作特征(ROC)曲线分析其对胎儿染色体异常的预测价值.结果:214例产前胎儿超声软指标异常孕妇中,脉络丛囊肿19例,其中3例染色体异常,16例染色体正常;脉络丛左、右侧囊肿直径与胎儿染色体异常呈正相关(rs=0.684、0.652,P<0.05);超声软指标脉络丛囊肿左、右侧直径对胎儿染色体异常预测的曲线下面积(AUC)分别为0.732(95%CI:0.685~0.784)与0.706(95%CI:0.662~0.753).结论:超声软指标脉络丛囊肿对胎儿染色体异常发生风险有较高预测价值,有助于早发现胎儿染色体异常,及时制定干预措施.

侧脑室脉络丛黄色肉芽肿的磁共振DWI与ADC诊断

目的探讨磁共振DWI结合ADC值对侧脑室脉络丛黄色肉芽肿的诊断价值。方法回顾性分析江油市人民医院30例侧脑室脉络丛黄色肉芽肿,6例脉络丛囊肿,9例脉络丛肿瘤患者的MRI影像表现,观察病变形态、大小、位置,T1WI、T2WI、T2-FLAIR及DWI(b=0,1000 s/mm^(2))信号特征,分别测量脉络丛黄色肉芽肿、脉络丛囊肿、脉络丛肿瘤以及侧脑室脑脊液ADC值。结果30例脉络丛黄色肉芽肿发生于60岁及以上年龄组18例(60%),60岁以下组12例(40%)。病灶大小0.4~2.4 cm,29例位于侧脑室三角区,1例位于侧脑室体部;发生于双侧26例,单侧4例,左、右侧各2例。病灶均呈结节状,T1W表现均匀低信号,T2WI表现均匀高信号,T2-FLAIR表现为等、稍高信号,DWI表现为高信号,ADC图呈等、稍低信号,ADC值(1.85±0.38)×10^(-3)mm^(2)/s,同时测得脉络丛囊肿、脉络丛肿瘤及侧脑室脑脊液ADC值分别为(3.06±0.12)×10^(-3)mm^(2)/s、(1.45±0.24)×10^(-3)mm^(2)/s、(3.18±0.35)×10^(-3)mm^(2)/s,脉络丛黄色肉芽肿与其两两比较差异均有统计学意义(P<0.05)。结论脉络丛黄色肉芽肿好发于老年人,对称分布于双侧脑室后角,常规T1WI、T2WI与脑脊液信号相似,DWI表现为高信号,结合ADC值具有一定的诊断及鉴别诊断价值。

儿童脉络丛癌12例临床特征及生存分析

背景儿童脉络丛癌(CPC)临床罕见,国内报道较少。目的 探讨儿童CPC的临床特征、治疗及结局。设计病例系列报告。方法 回顾性分析首都医科大学附属北京世纪坛医院儿科于2017年1月至2022年10月收治的手术后病理确诊的CPC患儿,随访截至2022年12月31日。截取患儿性别、诊断年龄、临床表现、治疗和随访情况,生存数据采用Kaplan-Meier法分析。主要结局指标总体生存期(OS)和无进展生存期(PFS)。结果 12例CPC患儿纳入分析,男4例,女8例;中位诊断年龄29.7(5.8~119.6)个月,起病年龄<3岁8例;肿瘤直径≥5 cm 8例,<5 cm 4例;肿瘤位于幕上9例,幕下3例;肿瘤位于脑室系统6例,脑室外累及脑实质6例;起病时发现播散转移2例,无转移10例。12例均接受肿瘤切除手术,全切8例,近全切4例。术后仅行化疗5例(42%),联合放射治疗及化疗7例(58%)。截至末次随访,8例出现肿瘤复发或进展,其中4例因肿瘤进展后死亡。平均OS(56.7±8.8)个月,1、3、5年OS率分别为(83.3±10.8)%、(66.7±13.6)%和(66.7±13.6)%。平均PFS(24.3±7.2)个月,1、3年PFS率分别为(41.7±14.2)%和(33.3±13.6)%。Kaplan-Meier单因素分析发现,肿瘤位于幕下3年OS低于幕上(χ^(2)=8.562,P=0.003);单纯化疗3年OS低于放化疗联合治疗(χ^(2)=8.488,P=0.004);不同性别、起病年龄(<3岁与3~18岁)、肿瘤直径(≥5 cm与<5 cm)、切除程度、有无转移、是否放化疗对3年PFS的影响差异均无统计学意义(P均>0.05)。结论 儿童CPC临床罕见,预后差,肿瘤位于幕下及单纯化疗为影响OS的不良预后因素。