背景:细胞神经鞘瘤(CS)是一种罕见的肿瘤,占所有良性神经鞘瘤的2.8-5.2%。文献中缺乏关于脊柱CS的最新信息。
目的:本研究的目的是确定脊柱良性神经鞘瘤中CS病例的比例,描述脊柱CS的临床特征,并通过分析93例连续CS病例的数据确定局部复发的预后因素。
方法:回顾性回顾。
方法:我们分析了2008年至2021年间在我们研究所接受治疗的1706例脊柱CS患者中筛查的93例PSGCT。
方法:人口统计学,射线照相,记录和分析手术和术后数据.
方法:我们比较了颈椎脊髓CS的临床特征,胸廓,腰椎和骶骨段。通过Kaplan-Meier方法确定无局部复发生存期(RFS)的预后因素。单因素分析中p≤0.05的因素采用Cox回归分析进行多因素分析。
结果:所有良性神经鞘瘤中脊柱CS的比例为6.7%。本研究中93例患者的平均和中位随访时间分别为92.2和91.0个月(范围为36至182个月)。11例局部复发,总复发率为11.7%,一个病人死亡。统计分析显示肿瘤大小≥5cm,病灶内切除,Ki-67≥5%是脊柱CSRFS的独立阴性预后因素。
结论:只要有可能,脊柱CS建议整块切除。肿瘤大小≥5cm且术后病理Ki-67≥5%的患者应进行长期随访。
BACKGROUND: Cellular schwannoma (CS) is a rare tumor that accounts for 2.8%-5.2% of all benign schwannomas. There is a dearth of up-to-date information on spinal CS in the literature.
OBJECTIVE: The aims of this
study were to identify the proportion of CS cases amongst spinal benign schwannoma, describe the clinical features of spinal CS, and identify prognostic factors for local recurrence by analyzing data from 93 consecutive CS cases.
METHODS: Retrospective review.
METHODS: We analyzed 93 PSGCT screened from 1,706 patients with spine CS who were treated at our institute between 2008 and 2021.
METHODS: Demographic, radiographic, operative and postoperative data were recorded and analyzed.
METHODS: We compared the clinical features of spinal CS from the cervical, thoracic, lumbar and sacral segments. Prognostic factors for local recurrence-free survival (RFS) were identified by the Kaplan-Meier method. Factors with p≤.05 in univariate analysis were subjected to multivariate analysis by Cox regression analysis.
RESULTS: The proportion of spinal CS in all benign schwannomas was 6.7%. The mean and median follow-up times for the 93 patients in this
study were 92.2 and 91.0 months respectively (range 36-182 months). Local recurrence was detected in 11 cases, giving an overall recurrence rate of 11.7%, with one patient death. Statistical analysis revealed that tumor size ≥5 cm, intralesional resection, and Ki-67 ≥5% were independent negative prognostic factors for RFS in spinal CS.
CONCLUSIONS: Whenever possible, en bloc resection is recommended for spinal CS. Long-term follow-up should be carried out for patients with tumor size ≥5 cm and postoperative pathological Ki-67 ≥5%.