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目的了解儿童胚芽细胞肿瘤的预后与临床因素的相关性。方法调查新华医院1985～1996年和上海儿童医学中心2000～2006年二个阶段收治的208例儿童胚芽细胞肿瘤病例,分析其发病年龄、部位、病理类型及临床分期,并作临床随访。结果208例不同部位肿瘤中,骶尾部肿瘤获诊年龄最早,其他依次为:腹膜后、睾丸、纵隔、卵巢。恶性肿瘤的发生率随年龄递增。200例获得病理诊断的肿瘤中,畸胎瘤占绝大多数,为81.5%,其他依次为:卵黄囊瘤15.0%、胚胎癌3.0%、精原细胞瘤0.5%。在各部位肿瘤中,睾丸肿瘤的病理类型最多。208例中106例(51.0%)获得长期随访,其中83例长期存活,23例复发死亡。结论病理类型、肿瘤部位及临床分期是影响儿童胚芽细胞肿瘤预后的重要因素,在过去10年中新生儿及低龄儿胚芽细胞肿瘤的生存率有了明显提高。
Objective To understand the prognosis of children with germ cell tumors and clinical factors. METHODS: A total of 208 cases of children with germ cell tumors admitted to Xinhua Hospital from 1985 to 1996 and Shanghai Children’s Medical Center from 2000 to 2006 were investigated. The age, location, pathological types and clinical stages of children were analyzed and followed up clinically. Results Among the 208 different tumor types, the sacrococcygeal tumors were the earliest recipients and the others were retroperitoneal, testis, mediastinum and ovary. The incidence of malignant tumors increases with age. Of the 200 pathologically diagnosed tumors, the majority of teratomas were found, accounting for 81.5%. The others were: yolk sac tumor 15.0%, embryo carcinoma 3.0% and seminoma 0.5%. In all parts of the tumor, the pathological types of testicular tumors most. Of the 208 patients, 106 (51.0%) were followed up for a long period of time, of which 83 survived long-term and 23 patients relapsed. Conclusion The pathological type, tumor location and clinical stage are the important factors affecting the prognosis of children with germ cell tumors. The survival rates of germ cell tumors of neonates and young children have been significantly improved in the past 10 years.