CAJ | 학술논문

目的探讨诊断性化疗诊治颅内生殖细胞瘤的可行性及临床意义.方法对13例血浆肿瘤标志物检测正常,临床表现高度提示可能为生殖细胞瘤,病理获取困难或风险较大的患者实施诊断性化疗.化疗采用顺铂+依托泊甙标准剂量方案,仅实施1个疗程,结束后10～ 14 d行CT或MRI复查.参考WHO实体瘤疗效评价标准判断化疗效果,并结合后期治疗的结果检验诊断性化疗的可靠性.结果完全缓解2例,部分缓解9例,无变化2例.完全缓解和部分缓解患者随后实施了放疗,治疗结果支持生殖细胞瘤诊断.2例诊断性化疗后无变化的患者,1例接受了手术,病理为胶质瘤Ⅱ级,另1例观察随访,半年后多次MRI复查证实为海绵状血管瘤.结论诊断性化疗具备区分生殖细胞瘤与非生殖细胞瘤的能力,对高度怀疑颅内生殖细胞瘤患者,可依靠其辅助确诊.
목적 탐토진단성화료진치로내생식세포류적가행성급림상의의.방법 대13례혈장종류표지물검측정상,림상표현고도제시가능위생식세포류,병리획취곤난혹풍험교대적환자실시진단성화료.화료채용순박+의탁박대표준제량방안,부실시1개료정,결속후10～ 14 d행CT혹MRI복사.삼고WHO실체류료효평개표준판단화료효과,병결합후기치료적결과검험진단성화료적가고성.결과 완전완해2례,부분완해9례,무변화2례.완전완해화부분완해환자수후실시료방료,치료결과지지생식세포류진단.2례진단성화료후무변화적환자,1례접수료수술,병리위효질류Ⅱ급,령1례관찰수방,반년후다차MRI복사증실위해면상혈관류.결론 진단성화료구비구분생식세포류여비생식세포류적능력,대고도부의로내생식세포류환자,가의고기보조학진.
Objective To explore and evaluate the feasibility and clinical significance of diagnostic chemotherapy in the diagnosis and treatment of intracranial germinoma.Methods Diagnostic chemotherapy was applied in 13 cases with germinoma related clinical manifestation and normal level of serum tumor marker,but difficulty or high risk in acquiring histopathologic sample.Only one course of standard cisplatin plus etoposide protocol was given,and CT or MRI was performed in 10-14 days after chemotherapy.The therapeutic effect was evaluated according to the WHO standard for chemotherapy of solid tumor.The reliability of diagnostic chemotherapy was also verified by long-term effect.Results 2 cases of complete response,9 cases of partial response and 2 cases of no response were observed.The cases of complete response and partial response underwent radiotherapy in the following treatment,and the result supported the diagnosis of germinoma.One of the two no-response cases received surgery and was proved to be a grade-Ⅱ glioma.The other one case of no response underwent no further treatment,and 6-month followup MRI demonstrated a cavernoma.Conclusions Diagnostic chemotherapy could be applied to identify germinoma and non-germinoma,and to confirm the diagnosis in case of high possibility of germinoma.