论文部分内容阅读
目的 分析儿童内胚窦瘤的特点 ,提高儿童内胚窦瘤的诊治水平。方法 对诊断明确的 9例内胚窦瘤患儿临床资料进行分析。结果 9例患儿发病年龄 3个月至 10岁 4个月 ,<3岁者 7例 ;男 5例 ,女 4例 ;Ⅰ期7例 ,Ⅱ期 1例 ,Ⅲ期 1例 ;原发于睾丸 4例 ,卵巢 2例 ,骶尾部 2例 ,中枢神经系统 1例。临床表现多为原发部位肿物及其压迫引起的相应症状 ,经B超可明确肿物存在。术前甲胎蛋白 (AFP) 7例升高 ,为 4 0 0～ 2 0 2 7mg/L ,无残留病变、转移者术后AFP均可降至正常。 4例睾丸内胚窦瘤Ⅰ期中 3例经根治性手术加术后PVB方案或VAC方案化疗 ,均获得大于 5年的生存期 ;原发卵巢、骶尾部内胚窦瘤 4例中 3例在Ⅱ期前手术、化疗获得至少 2年生存期。结论 小儿内胚窦瘤早期诊断、经手术加术后化疗是提高长期生存率的关键 ,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。
Objective To analyze the characteristics of children with endodermal sinus tumor and improve the diagnosis and treatment of endodermal sinus tumor in children. Methods The clinical data of 9 patients with definite endodermal sinus tumor were analyzed. Results 9 cases of children with onset of 3 months to 10 years and 4 months, 7 years of age <3 years; 5 males and 4 females; 7 cases of stage Ⅰ, 1 case of stage Ⅱ, 1 case of stage Ⅲ; 4 cases of testis, 2 cases of ovary, 2 cases of sacrococcygeal, central nervous system in 1 case. Most of the clinical manifestations of the primary site of the tumor and the corresponding symptoms caused by oppression, the B-clear tumor can exist. Seven cases of preoperative alpha-fetoprotein (AFP) were elevated to between 400 and 2207 mg / L, with no residual disease. The AFP in the metastatic group was reduced to normal after operation. In 4 cases of testicular endodermal sinus tumor, 3 cases were treated by radical surgery combined with PVB or VAC chemotherapy, all of them had a survival time of more than 5 years. Among 4 cases of primary ovarian and sacrococcygeal endodermal sinus tumors, 3 Ⅱ preoperative surgery, chemotherapy for at least 2 years of survival. Conclusion Early diagnosis of pediatric endodermal sinus tumors and surgery and postoperative chemotherapy are the keys to improve the long-term survival rate. AFP detection and B-ultrasound are important for the diagnosis and recurrence of children with endodermal sinus tumors.