儿童神经母细胞瘤伴骨髓转移5例临床分析.docxVIP

儿童神经母细胞瘤伴骨髓转移5例临床分析 (青岛市妇女儿童医院血液科 山东青岛266034) 【摘要】目的：总结儿童神经母细胞瘤(neuroblastoma, NB)伴骨髓转 移患儿的临床特点，提高对NB的认识。方法：回顾性分析青岛市妇女儿童医院 血液科2014年1月至2016年4月收治的神经母细胞瘤伴骨髓转移患儿的临床表 现、实验室检查。结果：5例患儿中，势3例，女2例。发病中位年龄3岁3月。 病程中位数13天。(1) 5例患儿中，4例发热，2例关节疼痛，2例腹痛，1例 咳嗽，1例走路不稳。(2) 5例患儿LDH、SF及CRP均升高。4例NSE升高。5 例患儿均贫血，白细胞及血小板未见异常。(3)5例患儿骨髓中均发现肿瘤细胞。 影像学证实肿瘤原发部位：后纵隔3例，腹膜后1例，肾上腺1例。结论： 儿童神经母细胞瘤伴骨髓转移者，临床表现呈非特异性，易误诊。 【关键词】神经母细胞瘤；骨髓转移；临床分析；儿童 【中图分类号】R73-37 【文献标识码】A 【文章编号】1007-8231 (2016) 24-0069-02 Clinical analysis of five Neuroblastoma with bone marrowme tastasis cases in childre n Zhuang Chao.Hematology Department of Qingdao women and childrens Hospital. Qingdao,266034. China [Abstract】Objective To improve the understanding of NB,the clinical characteristics of NB with bone marrow metastasis in childre n were con eluded. Methods Clin ical manifestation and laboratory exami nation were retrospectively analyzed about NB with bone marrow metastasis between January 2014 and April 2016 in Qingdao women and children hospital. Results Of the 5 cases, 3 male and 2 female.The median age was 3 years and 3 mon ths. The media n duration was 13 days. (1) Of the 5 cases, fever in 4 casesjoint pain in 4 cases ,abdominal pain in 2 cases. cough and walking in stability in 1 case.(2)LDH, SF, and CRP of 5 cases were higher. 4 cases of NSE in creased. 5 cases of childre n all with an emia, white blood cells and platelets were normal.(3) Cancer cells were found in bone marrow in 5 cases. (4)Primary site of tumor by imaging:3 cases in mediastinal J case in retroperitoneal,and 1 case in adrenal gland. Conclusion Clinical manifestations of NB in children with bone marrow metastasis are non-specific,and misdiagnosed easily. 【Key words] Neuroblastoma;Bone marrow;Clinical analysis;Child NB起源于交感神经节或双侧肾上腺，它是儿童期最常见的颅外实体瘤, 占儿童肿瘤死亡率的15%[l]o该病起病隐匿，病情进展快，恶性度高，临床表 现不典型，易误诊。为了加强对本病的认识，减少误诊，现将我院收治的5例神 经母细胞瘤伴骨髓转移患儿的临床特征进行分析和总结。 1.对象与方法 冋顾性分析和总结2014年1月至2016年4月在我院血液科病房收治的 5例神经母细胞瘤伴骨髓转移患儿的临床资料。 2 .结果 2.1 一般资料 5例患儿中，男3例，女2例，最大者8岁，最小者18个月，中位年