小儿骶尾部内胚窦瘤的治疗

目的探讨骶尾部内胚窦瘤的治疗和预后。方法回顾性分析1999年1月-2005年12月收治12例骶尾部内胚窦瘤患儿。该组病例术前经B超、CT或MRI检查发现骶尾部肿瘤,经检测血清甲胎蛋白均升高,采用手术切除全部或大部分肿瘤,所有患儿均采用BEP（顺铂十足叶乙甙＋博来霉素）方案化疗。结果该组病例术前经B超或CT检查发现骶尾部肿瘤,经检测血清甲胎蛋白（AFP）均升高,采用手术切除全部或大部分肿瘤,病理证实为内胚窦瘤。患儿均采用BEP（顺铂＋足叶乙甙＋博来霉素）方案化疗。随访6年,生存9例,死亡3例,复发5例。结论以顺铂为基础的联合化疗可改善内胚窦瘤疗效,AFP检测及B超联合应用对小儿内胚窦瘤诊断及复发监测有重要意义,选择恰当的手术方式并辅以联合化疗可提高患儿长期生存率。

Treatment of Sacrococcygeal Endodermal Sinus Tumor in Children

Objective To analyze treatment and prognosis of sacrococcygeal endodermal sinus tumor.Methods The clinical data of 12 children with sacrococcygeal endodermal sinus tumor were reviewed from Jan.1999 to Dec.2005.Results The sacrococcygeal tumor was found by type B-ultrasonic and CT before operation.Serum alpha fetoprotein (AFP) was elevated in all patients.All of the patients underwent surgery,totally or partially removed tumors.All cases were identified by postoperative pathology.The adjuvant combined chemotherapy was fo-llowed with BEP (bleomycin,etoposide and cisplatin).At 6 years follow-up,9 cases were survived,and 3 cases were died and 5 cases were recu-rrent.Conclusions Cisplatin-containing chemotherapy has improved the outlook for patients with endodermal sinus tumor;type-ultrasonic and AFP is valuable for diagnosis and postoperative monitoring,combination of optimal surgical resection and adjuvant combined chemotherapy seem to increase long-term survival rate for patients.