摘要
目的探讨儿童神经母细胞瘤(neuroblastoma,NB)2年内复发进展的危险因素及其对无进展生存(progression-free survival,PFS)的影响。方法选取2020年1~12月郑州大学第一附属医院收治的97例NB患儿进行回顾性研究,根据2年内复发进展与否分为复发进展组(n=33)和非复发进展组(n=64),分析影响儿童NB 2年内复发进展的危险因素,比较不同因素的PFS率。结果N-Myc基因扩增状态、国际神经母细胞瘤分期系统(international neuroblastoma staging system,INSS)NB分期是儿童NB 2年内复发进展的独立危险因素(P<0.05)。N-Myc基因扩增患儿的复发进展风险为非基因扩增患儿的2.676倍(P<0.05),INSS分期Ⅳ期患儿的复发进展风险为INSS分期Ⅰ、Ⅱ、Ⅲ、Ⅳs期患儿的4.308倍(P<0.05)。生存分析显示,N-Myc基因扩增患儿中位PFS为18个月,N-Myc基因扩增和未扩增患儿18个月PFS率分别为(46.7±12.9)%、(76.4±5.2)%。INSSⅣ期患儿中位PFS为23个月,Ⅳ期和Ⅰ、Ⅱ、Ⅲ、Ⅳs期患儿23个月PFS率分别为(56.3±7.2)%、(87.8±4.7)%,不同INSS分期NB患儿PFS率比较,差异有统计学意义(P<0.05)。结论复发进展是影响NB预后的关键因素,N-Myc扩增和INSS分期均为NB复发进展的独立危险因素且PFS率更低。
Objective To investigate the risk factors for recurrence or progression of neuroblastoma(NB)within 2 years and their influence on progression-free survival(PFS).Methods A retrospective analysis was performed for the clinical data of 97 children with NB who were admitted to the First Affiliated Hospital of Zhengzhou University from January to December 2020.According to the presence or absence of recurrence or progression,they were divided into recurrent or progression group with 33 children and non-recurrence or progression group with 64 children.The risk factors for recurrence or progression within 2 years were analyzed,and PFS was compared between the children with different risk factors.Results N-Myc amplification status and international neuroblastoma staging system(INSS)stage were risk factors for NB recurrence or progression within 2 years.The risk of recurrence of N-Myc gene amplification was 2.676 times than that of non-amplification(P<0.05).In the stage of INSSⅣstage,the risk of recurrence or progression was 4.308 times than that of INSSⅠ、Ⅱ、Ⅲ、Ⅳs stage(P<0.05).The survival analysis showed a median PFS period of 18 months in N-Myc gene amplifiers and an 18 months PFS rate of(46.7±12.9)%,and(76.4±5.2)%,respectively.The median PFS period of children with INSS stageⅣwas 23 months,and the PFS rate at 23 months of stageⅣgroup and stageⅠ,Ⅱ,ⅢandⅣs groups were(56.3±7.2)%and(87.8±4.7)%,respectively.The difference in PFS rate in different INSS stages with NB was significant(P<0.05).Conclusion Recurrence or progression is a key factor affecting NB prognosis in children,with both N-Myc gene amplification and INSS stage being independent risk factors for relapse progression and a lower PFS rate.
作者
李秀芩
赵鸽
贾佳
谢潭
杨林
张大
LI Xiuqin;ZHAO Ge;JIA Jia;XIE Tan;YANG Lin;ZHANG Da(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)
出处
《中国现代医生》
2023年第15期38-41,共4页
China Modern Doctor
