原发于纵隔的生殖细胞肿瘤47例临床分析

目的探讨原发于纵隔的生殖细胞肿瘤的临床特点、治疗方法及预后的影响因素。方法回顾性分析47例原发于纵隔的生殖细胞肿瘤患者的临床资料。结果47例患者中,男性41例,女性6例,中位年龄26岁;8例（17．0％）精原细胞瘤,39例（83．0％）非精原细胞瘤。全组患者中位生存期为16个月,1、3、5年生存率分别为63．4％、37．5％和34．8％;非精原细胞瘤患者1、3、5年生存率分别为56．4％、30．0％和27．3％,8例精原细胞瘤患者中,7例生存满5年。多因素分析显示,病理类型是原发于纵隔的生殖细胞肿瘤患者预后的独立影响因素（P=0．045）。结论纵隔精原细胞瘤患者对放疗、化疗敏感,预后较好;纵隔非精原细胞瘤患者预后差,化疗是其主要治疗手段,以顺铂为基础的化疗明显提高了这类患者的生存率。

Primary germ cell tumor in the mediastinum-report of 47 cases

Objective To investigate the clinical characterstics,effective treatment and prognosis in patients with primary germ cell tumors in the mediastinum.Methods The data of 47 such patients treated from 1967 to 2005 were retrospectively reviewed.Results Of these 47 patients,41 were male and 6 female with a median age of 26 years;8(17.0%)had seminoma,and 39(83.0%) non-seminoma.The overall 1-,3-,5-year survival rate was 63.4% ,37.5% and 34.8% with a median survival time of 16 months;which was 100% ,83.3% and 83.3% for seminoma and 56.4% ,30% and 27.3% for non- seminoma,respectively.The pathologic type was found to be the only independent prognostic factor (P= 0.045).Conclusion Primary mediastinal seminoma is sensitive to radiotherapy or chemotherapy with a good prognosis,but the prognosis of primary mediastinal non-seminoma is poor.Cisplatin-based chemotherapy still plays a key role in the treatment of primary mediastinal non-seminoma as the survival of those has been improved.