25例颅内多形性黄色星形细胞瘤临床病例分析

目的分析多形性黄色星型细胞瘤(PXA)的临床、影像及病理特点,探讨其有效治疗方法。方法回顾性纳入福建医科大学附属第一医院神经外科自2012年7月1日至2019年12月1日收治的25例颅内PXA患者,分析其临床表现、影像学特征、病理学特征及治疗方式,并随访研究其预后。结果25例患者中首发症状以头痛(12例)及癫痫(8例)最为常见。肿瘤位置多见于顶叶(8例),其次为颞叶(6例)、额叶(6例)。病理结果中,世界卫生组织(WHO)分级Ⅱ级患者肿瘤细胞增殖核抗原(Ki-67)平均阳性率为6.4%,P53平均阳性率21.2%;WHO分级Ⅲ级患者的Ki-67平均阳性率为22.2%,P53平均阳性率为48.3%。15例检测突触素(Syn)蛋白患者中阳性12例。20例患者术后随访31个月,存活19例,9例未见肿瘤复发或残留,其中WHOⅡ级8例,WHOⅢ级1例。结论病理结果在PXA诊断中发挥重要作用,WHOⅡ级患者预后明显优于Ⅲ级患者。

Diagnoses and treatments of pleomorphic xanthoastrocytoma:a clinical analysis of 25 cases

Objective To analyze the clinical,imaging and pathological characteristics of pleomorphic xanthoastrocytoma(PXA),and to explore the effective treatment of PXA.Methods A total of 25 patients with PXA admitted to our hospital from July 1,2012 to December 1,2019 were chosen in our study.Their clinical manifestations,imageology features,pathology features,treatments,and prognoses were retrospectively analyzed.Results Headache(n=12)and epilepsy(n=8)were the most common first symptoms in 25 patients.The tumors in 8 patients were located in the parietal lobe,6 were in the temporal lobe,and 6 were in the frontal lobe.Among the pathological results,the average positive rate of cell proliferation antigen Ki-67 and P53 in patients with WHO grading II was 6.4%and 21.2%,respectively;the average positive rate of Ki-67 and P53 in patients with WHO grading III was 22.2%and 48.3%,respectively.Synaptophysin protein was confirmed in 12 of the 15 patients.Twenty patients were followed up for 31 months after surgery;19 survived;9 had no tumor recurrence or residue,including 8 with WHO grading II and one with WHO grading III.Conclusion Pathological result play an important role in PXA diagnosis;the prognosis of patients with WHO grading II is obviously better than that of patients with WHO grading III.