毛细胞型星形细胞瘤的诊断与治疗

目的 探讨毛细胞型星形细胞瘤的临床诊断和最佳治疗方案。方法 通过头颅CT、MRI和手术探讨此类肿瘤的发病率,常见部位,临床特点,手术疗效,预后与手术切除肿瘤程度以及与术后放疗的关系。结果 毛细胞型星形细胞瘤以20岁以下发病率最高77．4％,以小脑居首92%。临床表现以颅内压增高为主、其次共济失调。影像学CT和MRI没有特征性征象,诊断率50％以上,最后确诊主要依靠病理学。预后与手术切除程度有关,肿瘤全切除术后10年内存活率达95％、部分切除术后达72．7％。结论 (1)毛细胞型星形细胞瘤多发病于青少年,以小脑居首。(2)尽可能全切除肿瘤、术后无需放疗其预后良好,可视为“良性肿瘤”;若不能伞切除的病例,术后可给予放疗亦能达到理想的预后。

Diagnosis and treatment of pilocytic astrocytoma

Objective To discuss the diagnosis and favorable management of pilocytic astrocytoma. Methods This is a paper for studing that the morbidity of pilocytic astrocytoma, the most frequently location of the tumor demonstrated by ct scan, magnetic resonance imaging (MRI) as well as operation, presenting signs and symptoms in clinic,the outcome of surgical treatment ,the relationship between the prognosis and extent of surgery as well as whether the addition of postoperative irradiation. Result Pilocytic astrocytoma most commonly occurs in 20 years of age or younger. The most frequent locations involved by tumor were cerebellum (92%).The most common presenting symptom was increased intracranial pressure, other presenting symptoms included ataxia.There were no characteristic signs in ct scan and cri. the diagnosis accurate rate in imaging is over 50%.Therefore, final diagnosis made depending on mainly pathology. We found the relationship between prognosis and the extent of surgical removal, The survival rate was 95% in total surgical excision and 72.7% in incompletely resection. Conclusion (1)Pilocytic astrocytomas are central nevous system tumors that usually occur in children and adolescents. The most common sites of these tumors are the cerebellum.(2)The prognosis of pilocytic astrocytoma is excellent, particularly making total excision as soon as possible in many cases. So it was called as "benign tumors". If pilocytic astrocytoma were subtotally excised, the addition of postoperative irradiation could significantly prolong survival.