[1]马木提江·木尔提扎　陈烈兴　吴　昊　麦麦提力·米吉提　朱国华　更·党木仁加甫.成人毛细胞型星形细胞瘤的诊治分析[J].中国临床神经外科杂志,2019,(12):724-726.[doi:10.13798/j.issn.1009-153X.2019.12.002]
　MAMUTIJIANG Muertizha,CHEN Lie-xing,WU Hao,et al.Diagnosis and surgical treatment of adult pilocytic astrocytomas[J].,2019,(12):724-726.[doi:10.13798/j.issn.1009-153X.2019.12.002]
点击复制

成人毛细胞型星形细胞瘤的诊治分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年12期
页码:
724-726
栏目:
论著
出版日期:
2019-12-24

文章信息/Info

Title:
Diagnosis and surgical treatment of adult pilocytic astrocytomas
文章编号:
1009-153X（2019）12-0724-03
作者:
马木提江·木尔提扎　陈烈兴　吴　昊　麦麦提力·米吉提　朱国华　更·党木仁加甫
830054 乌鲁木齐，新疆医科大学第一附属医院神经外科中心（马木提江·木尔提扎、陈烈兴、吴　昊、麦麦提力·米吉提、朱国华、更·党木仁加甫）
Author(s):
MAMUTIJIANG Muertizha;  CHEN Lie-xing;  WU Hao;  MAIMAITILI Mijiti;  ZHU Guo-hua;  GENG Dangmurenjiafu.
Department of Neurosurgery, The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China
关键词:
毛细胞型星形细胞瘤; 影像学特征; 显微手术治疗; 疗效
Keywords:
Pilocytic astrocytomas;  Radiographic characteristics;  Microsurgery;  Curative effect
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2019.12.002
文献标志码:
A
摘要:
目的 探讨成人毛细胞型星形细胞瘤（PA）的诊断、显微手术治疗效果。方法 回顾性分析2009年9月至2018年12月新疆医科大学第一附属医院神经外科手术治疗的31例成人PA的临床资料。结果 肿瘤全切除17例，近全切除4例，次全切除6例，部分切除2例，活检2例。术后主要并发症包括脑积水3例（9.7%）、颅内感染4例（12.9%）、脑脊液漏3例（9.7%）。26例术后随访3~93个月；死亡3例（11.5%）；肿瘤复发或进展5例（19.2%），平均复发时间（25.6±16.9）个月，其中2例再次手术，肿瘤全切除本人随访期间未见肿瘤复发。结论 成人PA临床少见，影像学常不易与其它低级别胶质瘤鉴别，而典型的组织细胞学特点是其确诊依据；肿瘤全切除的本人能获得较满意的治疗效果，放疗为PA的主要辅助治疗方式。
Abstract:
Objective To investigate the diagnosis, microsurgical treatment and postoperative complications of adult pilocytic astrocytomas. Method The clinical data of 31 adult patients with pilocytic astrocytomas, who underwent microsurgery in The First Hospital Affiliated to Xinjiang Medical University from September, 2009 to December, 2018, were analyzed retrospectively. Results Of 31 patients, 17 (54.8%) received gross total resection of the tumors, 10 (32.3%) subtotal resection, 2 (6.5%) partial resection and 2 (6.5%)only biopsy. The main postoperative complications included hydrocephalus in 3 patients (9.7%), intracranial infection in 4 (12.9%), and 3 cases (9.7%) cerebrospinal fluid leakage in 3 (9.7%). Of 26 patients followed up via outpatient or telephone for 3~93 months, 3 died, 5 suffered from the recurrence of the tumors and 18 were recovered well. Conclusions Pilocytic astrocytoma rarely occurs in the adults, and its diagnosis depends on the histopathological examination because it is difficult to differentiate the tumor radiologically from the low WHO grade glioma. The curative effect of microsurgery on the pilocytic astrocytoma is good. The postoperative radiotherapy may be helpful to the improvement of the prognosis in the patient with pilocytic astrocytoma.

参考文献/References:

[1] Reis GF, Tihan T. Practical molecular pathologic diagnosis of pilocytic astrocytomas [J]. Surg Pathol Clin, 2015, 8(1): 63-71.
[2] Xia J, Yin B, Liu L, et al. Imaging features of pilocytic astro- cytoma in cerebral ventricles [J]. Clin Neuroradiol, 2016, 26 (3): 341-346.
[3] Collins VP, Jones DT, Giannini C. Pilocytic astrocytoma: pathology, molecular mechanisms and markers [J]. Acta Neuropathol, 2015, 129(6): 775-788.
[4] Nelson AJ, Zakaria R, Jenkinson MD, et al. Extent of resec- tion predicts risk of progression in adult pilocytic astrocy- toma [J]. Br J Neurosurg, 2019, 33(3): 343-347.
[5] Ishkanian A, Laperriere NJ, Xu W, et al. Upfront observa- tion versus radiation for adult pilocytic astrocytoma [J]. Cancer, 2011, 117(17): 4070-4079.
[6] 朱庆庆，武乐斌，王光彬. 毛细胞型星形细胞瘤影像学诊 断现状[J]. 医学影像学杂志，2009，19（3）：348-351.
[7] Bond KM, Hughes JD, Porter, AL, et al. Adult Pilocytic Astrocytoma: an institutional series and systematic literature review for extent of resection and recurrence [J]. World Neurosurg, 2018, 110: 276-283.
[8] Theeler BJ, Ellezam B, Sadighi ZS, et al. Adult pilocytic astrocytomas: clinical features and molecular analysis [J]. Neuro Oncol, 2014, 16(6): 841-847.
[9] 罗似亮，吾太华，邓少勇，等. 毛细胞型星形细胞瘤的预后 因素分析[J]. 中华神经外科杂志，2018，34（8）：815-819.
[10] Chu TPC, Shah A, Walker D, et al. Where are the opportu- nities for an earlier diagnosis of primary intracranial tumo- urs in children and young adults [J]? Eur J Paediatr Neurol, 2017, 21(2): 388-395.
[11] Dutta G, Singh D, Singh H, et al. Pilocytic astrocytoma of the cerebellopontine angle mimicking vestibular schwan- noma: report of a rare entity [J]. Br J Neurosurg, 2017, 26: 1-3.
[12] Gutmann DH, McLellan MD, Hussain I, et al. Somatic neu- rofibromatosis type 1 (NF1) inactivation characterizes NF1- associated pilocytic astrocytoma [J]. Genome Res, 2013, 23 (3): 431-439.
[13] Janzarik WG, Kratz CP, Loges NT, et al. Further evidence for a somatic KRAS mutation in a pilocytic astrocytoma [J]. Neuropediatrics, 2007, 38(2): 61-63.
[14] Pathak P, Kumar A, Jha P, et al. Genetic alterations related to BRAF-FGFR genes and dysregulated MAPK/ERK/ mTOR signaling in adult pilocytic astrocytoma [J]. Brain Pathol, 2017, 27(5): 580-589.
[15] Perilongo G. Considerations on the role of chemotherapy and modern radiotherapy in the treatmentof childhood low grade glioma [J]. J Neurooncol, 2005, 75(3): 301-307.

相似文献/References:

[1]武　强　窦长武　张占普　富春雨　高乃康.中枢神经细胞瘤的影像特征及显微手术治疗 （附11例报告）[J].中国临床神经外科杂志,2016,(05):298.[doi:10.13798/j.issn.1009-153X.2016.05.014]
[2]李　鑫　刘少波　谢志敏　谷万春.颅脑损伤CT影像特点与颅内压及预后的相关性[J].中国临床神经外科杂志,2016,(08):487.[doi:10.13798/j.issn.1009-153X.2016.08.015]
[3]秦　汉　胡军民　元　玲　秦海林　安学锋　雷　颉.多形性黄色瘤型星形细胞瘤的诊治分析：附7例报道并文献复习[J].中国临床神经外科杂志,2019,(12):721.[doi:10.13798/j.issn.1009-153X.2019.12.001]
　QIN Han,HU Jun-min,YUAN Ling,et al.Diagnosis and treatment of pleomorphic xanthoastrocytomas and review of literature related to them (report of 7 cases)[J].,2019,(12):721.[doi:10.13798/j.issn.1009-153X.2019.12.001]
[4]于贝贝　荆林凯　王　劲等.脊髓毛细胞型星形细胞瘤的诊断与治疗[J].中国临床神经外科杂志,2021,26(03):153.[doi:10.13798/j.issn.1009-153X.2021.03.003]
　YU Bei-bei,JING Lin-kai,WANG Bo,et al.Diagnosis and treatment of spinal cord pilocytic astrocytoma (report of 12 cases)[J].,2021,26(12):153.[doi:10.13798/j.issn.1009-153X.2021.03.003]
[5]周　建　钟旺旺　唐建建　陈政纲　杨　堃.脑静脉、静脉窦血栓形成的影像特征分析[J].中国临床神经外科杂志,2021,26(05):330.[doi:10.13798/j.issn.1009-153X.2021.05.004]
　ZHOU Jian,ZHONG Wang-wang,Tang Jian-jian,et al.Analysis of imaging characteristics of patients with cerebral vein and sinus thrombosis[J].,2021,26(12):330.[doi:10.13798/j.issn.1009-153X.2021.05.004]
[6]苏建云　强召展　杨张凯　米伟阳　张　刚　史永强　李　楠　史航宇.儿童舞蹈活动致急性脊髓损伤的治疗分析（附8例报道并文献复习）[J].中国临床神经外科杂志,2022,27(04):249.[doi:10.13798/j.issn.1009-153X.2022.04.003]
　SU Jian-yun,QIANG Zhao-zhan,YANG Zhang-kai,et al.Clinical analysis of acute spinal cord injury caused by children’s dancing activities: eight cases report and literature review[J].,2022,27(12):249.[doi:10.13798/j.issn.1009-153X.2022.04.003]
[7]王克强,常新,黄玉兴.58例硬脊膜动静脉瘘的临床分析[J].中国临床神经外科杂志,2022,27(06):489.[doi:10.13798/j.issn.1009-153X.2022.06.019]
[8]杨宇浩,李照建,李卓群,等.垂体Rathke囊肿蛋白小体的影像学特征分析[J].中国临床神经外科杂志,2022,27(07):561.[doi:10.13798/j.issn.1009-153X.2022.07.010]
　YANG Yu-hao,LI Zhao-jian,LI Zhuo-qun,et al.Imaging features of intracystic nodules in Rathke cleft cysts: a preliminary study in a single center[J].,2022,27(12):561.[doi:10.13798/j.issn.1009-153X.2022.07.010]
[9]安学锋,赵曰圆,秦杰,等.软脑膜动静脉瘘的血管内介入治疗分析[J].中国临床神经外科杂志,2022,27(08):625.[doi:10.13798/j.issn.1009-153X.2022.08.001]
　AN Xue-feng,ZHAO Yue-yuan,QIN Jie,et al.Clinical analysis of endovascular interventional therapy for patients with pial arteriovenous fistula: report of 9 cases and literature review[J].,2022,27(12):625.[doi:10.13798/j.issn.1009-153X.2022.08.001]
[10]吴大号,王常贞,林涛.脑静脉、静脉窦血栓形成的临床特征[J].中国临床神经外科杂志,2023,28(01):43.[doi:10.13798/j.issn.1009-153X.2023.01.013]

备注/Memo

备注/Memo:
通讯作者：更·党木仁加甫，E-mail：damrjab@163.com（2019-07-30收稿，2019-10-08修回）
更新日期/Last Update: 2019-12-23