颅咽管瘤的临床特征与预后的相关因素分析

目的研究影响颅咽管瘤术后治疗效果的相关临床因素。方法回顾性分析60例颅咽管瘤患者的临床资料。结果肿瘤全切40例，次全切14例，大部分切除6例；症状改善（有效）44例，恶化10例，死亡6例。术后病理学结果显示釉质上皮型49例，鳞状乳头型11例。釉质上皮型肿瘤直径为2-4cm所占比例（32．7％，16／49）明显低于鳞状乳头型（81．8％，9／11，P〈0．05），而直径〉4cm所占比例（61．2％，30／49）明显高于鳞状乳头型（9．1％，1／11，P〈0．05），釉质上皮型肿瘤呈实性所占比例（6．8％，4／49）明显低于鳞状乳头型（36．4％，4／11，P〈0．05）。手术有效的患者中肿瘤大部分切除所占比例（2．3％，1／44）明显低于手术无效（恶化＋死亡）的患者（31．3％，5／16，P〈0．05）。结论不同病理学类型的颅咽管瘤患者在肿瘤大小及肿瘤成分上存在较大差异，肿瘤切除程度是影响颅咽管瘤患者手术治疗效果的重要因素。

Clinical features of craniopharyngioma and analysis of factors related to its prognosis

Objective To study the factors related to the clinical curative effect of microsurgery on craniopharyngioma. Methods The clinical data of 60 patients with craniopharyngiomas treated in our hospital were analyzed retrospectively. The factors related to the clinical curative effect of the microsurgery on craniopharyngioma were statistically analyzed. Results Of 60 craniopharyngiomas, 40 were totally resected, 14 subtotally and 6 in great part. The symptoms were relieved in 44 patients and deteriorated in 16. There were significance differences in the tumorous size and features （cystic degeneration or not） between adamatinomatous craniopharyngiomas and squamous papillary craniopharyngiomas （P〈0.05）. There were significant differences in the curative effect among the different resection of the tumors in degree groups （P〈0.01）. Conclusions The adamatinomatous craniopharyngiomas with cystic degeneration are significantly more than the squamous papillary craniopharyngiomas with cystic degeneration. The curative effect of the surgery on the craniopharyngiomas may be enhanced by the total resection of the tumors as possible.