嗅神经母细胞瘤诊断与治疗的临床分析

目的探讨鼻腔嗅神经母细胞瘤的诊断治疗方法及预后的相关因素。方法回顾性分析我院1994年1月-2010年5月收治的嗅神经母细胞瘤12例，改良Kadish分期A期1例，B期5例，C期3例，D期3期。含手术的综合治疗6例，单独手术4例，单独放疗1例，单独化疗1例。结果全组患者5年总生存率（OS）为90.9%，5年无病生存率（DFS）为74.1%。A、B期和C、D期患者的5年OS分别为100%和80.0%（χ²=1.20，P=0.27），5年DFS分别为100%和44.4%（χ²=4.07，P=0.04）。有淋巴结转移和无淋巴结转移患者的5年OS分别为66.7%和100%（χ²=2.67，P=0.10），5年DFS分别为33.3%和87.5%（χ2=4.88，P=0.03）。综合治疗与单一治疗的5年OS分别为100%和80.0%（χ²=1.20，P=0.27）,5年DFS分别为83.3%和62.5%（χ2=0.35，P=0.88）。结论嗅神经母细胞瘤的早期诊断较难，该病的治疗以综合治疗疗效较好，放疗是该病重要的治疗手段，该病预后与疾病分期及淋巴结转移情况相关。

Diagnosis and Treatment of Esthesioneuroblastoma

Objective
To discuss correlation factor of diagnosis,treatment and prognosis of esthesioneuroblastoma (ENB).Methods The
data of 12 patients with ENB treated from January 1994 to May 2010 were retrospectively reviewed in this
study.one patient had modified Kadish stage A disease,five patients had modified Kadish stage B disease,three
patients stage C,three patients in stage D.six patients were treated with comprehensive therapies including
surgery,four patients were treated with surgery alone,one patient was treated with radiotherapy alone,one patient
was treated with chemotherapy alone.ResultsThe 5-year overall survival (OS) and disease free survival (DFS) of
the whole group were 90.9% and 74.1% respectively.The 5-year OS of modified Kadish’s stage A,B and C,D were 100%
and 80.0%（χ²=1.20，P=0.27）.And the 5-year DFS were 100% and 44.4%（χ²=4.07，P=0.04）,respectively.The 5-year
OS for patients with cervical lymph node metastasis and without cervical lymph node metastasis were 6.7% and 100%
（χ²=2.67，P=0.10） The 5-year DFS were 33.3% and 87.5%（χ²=4.88，P=0.03）.The 5-year OS for patients treated
with combined therapy and single treatment were 100% and 80.0%（χ²=1.20，P=0.27）,the 5-year DFS of them were
83.3% and 62.5%（χ²=0.35，P=0.88）,respectively.ConclusionIt’s difficult for early diagnose of ENB,the
therapeutic effect of comprehensive therapy is better,radiotherapy is important for ENB.The prognosis of this
disease is connected with the stage of the disease and lymph node metastasis.