[1]张治元　王汉东　樊友武　贾　玥　吴晋蓉.胶质肉瘤15例分析及文献复习[J].中国临床神经外科杂志,2018,(02):69-71.
　ZHANG Zhi-yuan,WANG Han-dong,FAN You-wu,et al.Diagnosis and treatment of gliosarcoma: a report of 15 cases and literature review[J].,2018,(02):69-71.
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胶质肉瘤15例分析及文献复习()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年02期
页码:
69-71
栏目:
论著
出版日期:
2018-03-05

文章信息/Info

Title:
Diagnosis and treatment of gliosarcoma: a report of 15 cases and literature review
文章编号:
1009-153X（2018）02-0069-03
作者:
张治元　王汉东　樊友武　贾　玥　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、贾　玥），病理科（吴晋蓉）
Author(s):
ZHANG Zhi-yuan1;  WANG Han-dong1;  FAN You-wu1;  JIA Yue1;  WU Jin-rong2.
1. Department of Neurosurgery, Nanjing Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China; 2. Department of Pathology, Nanjing Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China
关键词:
胶质肉瘤; 胶质母细胞瘤; 临床特点; 诊断; 治疗
Keywords:
Gliosarcomas;  Diagnosis;  Treatment;  Clinical features;  Metastasis
分类号:
R 739.41; R 651.1+1
文献标志码:
A
摘要:
目的 探讨胶质肉瘤的诊断及治疗。方法 回顾性分析15例经病理证实的胶质肉瘤的临床资料。结果 9例以颅内压增高为主要临床表现，伴有局部功能障碍；2例发生颅外转移；影像学检查显示，全部位于大脑半球凸面，多数边界不清楚，类似胶质母细胞瘤表现；少数与硬脑膜、颅骨关系密切，呈均匀明显强化，类似脑膜瘤；平均生存期为13个月；病理检查示肿瘤细胞呈多形性，主要由胶质母细胞瘤细胞和肉瘤细胞2种成分组成，胶质纤维酸性蛋白免疫组化染色均阳性。失访3例，其余12例术后随访6个月~8年，正常生活8例，生活自理2例，生活需要照顾2例；复发10例，颅外转移2例，其中死亡8例。结论 胶质肉瘤为高度恶性胶质瘤，易侵犯脑膜、颅骨并发生颅外转移。胶质肉瘤确诊有赖于病理学检查。手术切除是胶质肉瘤的主要治疗方法，术后放化疗有助于改善病人预后。与胶质母细胞瘤比较，胶质肉瘤预后更差。
Abstract:
Objective To investigate the diagnosis and treatment of gliosarcomas. Methods The clinical data of patients with gliosarcomas which were pathologically confirmed were analyzed retrospectively. Results The main clinical symptoms were high intracranial pressure and local dysfunctions. Two patients had extracranial metastases. Imaging features: all the tumors were in the cerebral cortex; most of them were similar to glioblastomas without clear border in the findings on the imaging; the parts of gliosarcomas were similar to the meningiomas in the fingdings on the imaging, which were significantly enhanced, and closely related to the dura and skull. Gliosarcoma, in which the cells were pathologically polyomorphic, mainly consisted of both the glioblastoma and gliosarcoma cells, and had immunohistochemically positive glial fibrillary acidic protein. Of 15 patients with gliosarcomas, 10 received total resection of the tumors, 3 subtotal and 2 parts. Of 12 patients who were followed up from 6 months to 8 years, 10 had the tumorous recurrence and 2 not. Eight patients died during the following-up. Conclusions Gliosarcoma, which is one of most malignant gliomas, tends to invade the meninges and skull, and easily metastasizes extracranially. The diagnosis of gliosarcoma depends on the histopathological examination. Surgical resection is the main method to treat gliosarcoma. Postoperative radiotherapy and chemotherapy can improve the prognoses in the patients with gliosarcomas. The prognosis is worse in the patients with gliosarcomas than that in the patients with glioblastomas.

参考文献/References:

[1] 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(6): 803-820.
[2] Castelli J, Feuvret L, Haoming QC, et al. Prognostic and therapeutic factors of gliosarcoma from a multi-institutional series [J]. J Neurooncol, 2016, 129(1): 85-92.
[3] Beaumont TL, Kupsky WJ, Barger GR, et al. Gliosarcoma with multiple extracranial metastases: case report and review of the literature [J]. J Neurooncol, 2007, 83: 39-46.
[4] Zhang G, Huang S, Zhang J, et al. Clinical outcome of gliosarcoma compared with glioblastoma multiforme: a clinical study in Chinese patients [J]. J Neurooncol, 2016, 127(2): 355-362.
[5] 王宏伟，刘玉光. 胶质肉瘤的临床特点与治疗（附9例报 告及文献复习）[J]. 中华神经外科杂志，2011，27（4）： 494-497.
[6] Lee J, Rodriguez F, Ali SZ. Metastatic gliosarcoma: cytopa- thologic characteristics with histopathologic correlations [J]. Acta Cytol, 2016, 60(5): 490-494.
[7] 陈立军，杜固宏，毛　颖. 54例胶质肉瘤临床特征分析[J]. 医学临床研究，2010，27（3）：414-417.
[8] Adeberg S, Bernhardt D, Harrabi SB, et al. Radiotherapy plus concomitant temozolomide in primary gliosarcoma [J]. J Neurooncol, 2016, 128(2): 341-348.

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更新日期/Last Update: 2018-03-05