[1]张治元　王汉东　樊友武　吴晋蓉.多形性黄色星形细胞瘤的诊断与治疗（附22例分析）[J].中国临床神经外科杂志,2017,(12):801-803.[doi:10.13798/j.issn.1009-153X.2017.12.001]
　HANG Zhi-yuan,WANG Han-dong,FAN You-wu,et al.Diagnosis and treatment of pleomorphic xanthoastrocytoma: a report of 22 cases[J].,2017,(12):801-803.[doi:10.13798/j.issn.1009-153X.2017.12.001]
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多形性黄色星形细胞瘤的诊断与治疗（附22例分析）()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年12期
页码:
801-803
栏目:
论著
出版日期:
2017-12-25

文章信息/Info

Title:
Diagnosis and treatment of pleomorphic xanthoastrocytoma: a report of 22 cases
文章编号:
1009-153X（2017）12-0801-03
作者:
张治元　王汉东　樊友武　吴晋蓉
作者单位：210002 南京，中国人民解放军南京总医院暨南京大学医学院南京金陵医院神经外科（张治元、王汉东、樊友武），病理科（吴晋蓉）
Author(s):
HANG Zhi-yuan;  WANG Han-dong;  FAN You-wu;  WU Jin-rong.
Department of Neurosurgery, Nanjing Jinling Hospital , School of Medicine, Nanjing University, Nanjing 210002, China
关键词:
多形性黄色星形细胞瘤; 诊断; 治疗
Keywords:
Pleomorphic xanthoastrocytoma;  Diagnosis;  Treatment;  Curative effect
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.12.001
文献标志码:
A
摘要:
目的 探讨多形性黄色星形细胞瘤（PXA）的诊断及治疗。方法 回顾性分析2008年10月至2016年12月手术治疗的22例PXA的临床资料。结果 术中显微镜下和术后MRI复查证实肿瘤全切除16例，次全切除4例，部分切除2例。术后发生皮下积液3例、颅内感染2例、肺部感染1例，经对症治疗后痊愈。术后病理示，WHO Ⅱ级13例，Ⅲ级9例；免疫组化染色：胶质纤维酸性蛋白（+++），CD34（+++），Ki-67（灶状阳性），网状纤维（+）。19例术后随访1~8年，正常工作、生活10例，生活自理4例，生活需要照顾2例，死亡3例。复查MRI显示，肿瘤复发再次行手术7例；3例肿瘤呈多灶性复发，放弃进一步治疗死亡；其余9例随访期内未见明显肿瘤复发。结论 PXA多表现为良性肿瘤，少数病例有恶变的可能。MRI对PXA的诊断、手术以及术后预后判断具有积极意义，病理诊断是确诊的主要依据。肿瘤有残余、复发或间变型PXA，术后建议放、化疗，以改善预后。
Abstract:
【Abstract】Objective To investigate the diagnosis and treatment of pleomorphic xanthoastrocytoma (PXA). Methods The clinical data of 22 patients with PXA confirmed by postoperative pathological examination who underwent surgery through different approach were analyzed retrospectively. Results The main clinical symptoms included epilepsy, headache and so on. Of 22 PXA, 63.6% were located in the cerebral cortex and 66.7% cystic. Most PXA cells were pleomorphic ones with immunohistochemically positive GFAP. Of 22 patients with PXA, 16 received total resection of PXA, 4 subtotal and 2 part. Nineteen patients were followed up for 1 to 8 years. Ten patients had normal life, 4 had self-care capacity, 2 needed care for activities of daily living and 3 died during the following-up. PXA recurred in 10 patients. Conclusions Most of PXA are of the characters of benign tumors, but a small number of PXA may have malignant potential. MRI is of value for diagnosis, surgical resection and assessment of prognosis of PXA. The definite diagnosis of PXA depends on the histopathological examination. Radiotherapy and/or chemotherapy should be performed after the surgery in the patients with residual tumors or aanaplastic PXA or recurrent PXA in order to improve the patients’ prognoses.

参考文献/References:

[1] Kepes JJ, Rubinstein LJ, Eng LF. Pleomorphic xanthoastro- cytoma: a distinctive meningocerebral glioma of young sub- jects with relatively favorable prognosis: a study of 12 cases [J]. Cancer, 1979, 44: 1839-1852. [2] Louis DN, Perry A, Reifenberger G, et al. The 2016 world health organization classification of tumors of the central nervous system: a summary [J]. Acta Neuropathol, 2016, 131: 803-820. [3] Schmidt Y, Kleinschmidt-DeMasters BK, Aisner DL, et al. Anaplastic PXA in adults: case series with clinicopathologic and molecular features [J]. J Neurooncol， 2013, 111: 59- 69. [4] Gaba P, Puffer RC, Hoover JM, et al. Perioperative outcomes in intracranial pleomorphic xanthoastrocytoma [J]. Neuro- surgery, 2016. Epub ahead of print. [5] Crespo-Rodriguez AM, Smirniotopoulos JG, Rushing EJ. MR and CT imaging of 24 pleomorphic xanthoastrocytomas (PXA) and a review of the literature [J]. Neuroradiology, 2007, 49: 307-315. [6] Cicuendez M, Martinez-Saez E, Martinez-Ricarte F, et al. Combined pleomorphic xanthoastrocytoma-ganglioglioma with BRAF V600E mutation: case report [J]. J Neurosurg Pediatr, 2016, 18: 53-57. [7] Marton E, Feletti A, Orvieto E, et al. Malignant progression in pleomorphic xanthoastrocytoma: personal experience and review of the literature [J]. J Neurol Sci, 2007, 252: 144- 153. [8] Lohkamp LN, Schinz M, Gehlhaar C, et al. MGMT promoter methylation and BRAF V600E mutations are helpful mar- kers to discriminate pleomorphic xanthoastrocytoma from giant cell glioblastoma [J]. PLoS One, 2016, 11: e0156422. [9] Rutkowski MJ, Oh T, Niflioglu GG, et al. Pleomorphic xanthoastrocytoma with anaplastic features: retrospective case series [J]. World Neurosurg, 2016, 95: 368-374.

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备注/Memo

备注/Memo:
通讯作者：王汉东，E-mail：njhdwang@hotmail.com
更新日期/Last Update: 2017-12-27