131例纵隔原发性神经源性肿瘤手术治疗的临床经验分析

发布时间：2018-04-02 10:34

本文选题：纵隔肿瘤　切入点：神经源性肿瘤　出处：《复旦学报(医学版)》2017年02期

【摘要】：目的分析纵隔原发性神经源性肿瘤行手术治疗患者的临床特征、治疗方法和预后情况。方法回顾性分析复旦大学附属中山医院胸外科2008年1月至2014年12月期间已行手术且病理证实为纵隔原发性神经源性肿瘤共131例患者的临床资料,包括临床特征、影像学表现、手术方式、病理学形态和预后。结果 131例患者中男性78例(59.5%),女性53例(40.5%);有症状者59例(45.0%),无症状者72例(55.0%);肿瘤位于左后纵隔61例,右后纵隔69例,前纵隔1例。电视辅助胸腔镜手术(video-assisted thoracic surgery,VATS)98例(74.8%),VATS辅助胸部小切口手术5例(3.8%),开胸手术28例(21.4%)。除1例恶性神经鞘瘤行姑息性切除外,其他均完整切除,无围手术期死亡。病理类型显示良性神经鞘瘤98例(74.8%),神经节细胞瘤24例(18.3%),恶性神经鞘瘤2例(1.5%),神经纤维瘤2例(1.5%),副神经节瘤2例(1.5%),原始神经外胚层肿瘤(primitive neurotodermal tumour,PNET)2例(1.5%),神经母细胞瘤1例(0.8%)。术后随访12~95个月,平均53个月,1例PNET因肿瘤广泛转移死亡,1例恶鞘姑息切除术后20天死亡,2例因其他原因死亡,其余均无瘤存活至2016年1月。结论纵隔神经源性肿瘤多无特异性临床症状,绝大部分为良性,手术切除预后良好,但恶性肿瘤则预后较差。
[Abstract]:Objective to analyze the clinical characteristics of patients with primary mediastinal neurogenic tumor undergoing surgical treatment. Methods the clinical data of 131 patients with primary mediastinal neurogenic tumor confirmed by pathology from January 2008 to December 2014 in Zhongshan Hospital affiliated to Fudan University were analyzed retrospectively. Results among 131 patients, 78 cases were male and 53 cases were female. 59 cases had symptoms, 59 cases had symptoms, 72 cases had no symptoms, 61 cases were located in left posterior mediastinum, 69 cases had right posterior mediastinum. One case of anterior mediastinum. Video-assisted thoracic Surgeryus VATSN was performed in 98 cases with vats assisted thoracic small incision operation in 5 cases and thoracotomy in 28 cases with 21. 4 position. All but 1 case underwent palliative resection of malignant neurilemmoma, and all other cases were resected completely. No perioperative death. Pathological types showed benign neurilemmoma in 98 cases, ganglioneurocytoma in 24 cases, malignant neurinoma in 2 cases, neurofibroma in 2 cases, paraganglioma in 2 cases, paraganglioma in 2 cases, primary neurotodermal tumour in 2 cases, neuroectodermal tumor in 2 cases, neurofibroma in 2 cases, primordial neuroectodermal tumor in 2 cases, primary neurotodermal tumor in 2 cases, neurofibroma in 2 cases, neuroectodermal tumor in 2 cases, neuroectodermal tumor in 2 cases. One case with neuroblastoma was followed up for 12 ~ 95 months. One case of PNET died of extensive metastasis in an average of 53 months. One case died 20 days after palliative resection of malignant sheath, 2 cases died of other causes, and the rest survived until January 2016. Conclusion mediastinal neurogenic tumors have no specific clinical symptoms. Most of the patients were benign and had a good prognosis after surgical resection, but the prognosis of malignant tumors was poor.
【作者单位】：复旦大学附属中山医院胸外科;复旦大学附属中山医院病理科;
【基金】：国家自然科学基金(81401875)~~
【分类号】：R734.5

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