Analysis of Surgically Treated Intraspinal Tumors in Southern Taiwan

高雄醫學大學近五年脊椎脊髓腫瘤之分析

蘇裕峰(Yu-Feng Su) ； 劉安祥(Ann-Shung Lieu) ； 林志隆(Chih-Lung Lin) ； 李昆興(Kung-Shing Lee) ； 黃燕芬(Yen-Fen Hwang) ； 顏俊博(Chun-Po Yen) ； 張志任(Chih-Zen Chang) ； 羅永欽(Joon-Khim Loh) ； 黃祖源(Tzuu-Yuan Huang) ； 黃旭霖(Shiuh-Lin Hwang) ； 關皚麗(Aij-)

《The Kaohsiung Journal of Medical Sciences》 23卷11期 (2007/11) Pp. 573-578

摘要

本研究分析1999年1月至2004年4月期間在高雄醫學大學附設中和紀念院神經外科接受手術的117例脊椎腫瘤的流行病學特性。並與我們於1997年所發表的統計資料比較。脊椎脊髓腫瘤的病理分類依發生率為轉移性腫瘤(45.3%)，神經細胞膜腫瘤(28.2%)，脊膜瘤(12%)，神經膠瘤(6%)等。脊椎脊髓腫瘤的男性病患較多，但脊膜瘤以女性為主。年齡為13-87歲，平均的年齡為51.9歲。好發的年齡層為30-70歲，以41-50及61-70歲者有較高的比率。脊椎脊髓腫瘤所佔脊椎位置主要胸椎(50.4%)，依次為腰薦椎(27.4%)及頸椎(22.2%)。解剖位置上，脊膜外(51.3%)與脊膜內脊髓外(38.5%)佔多數。脊膜外腫瘤主要是轉移性腫瘤，脊膜內脊髓外腫瘤則是神經細胞膜腫瘤及脊膜瘤。轉移性腫瘤的來源最多的是肺癌及乳癌。來源不明的轉移性腫瘤仍佔有15.1%。與1997年的統計資料比較，轉移性腫瘤的比率超越神經細胞膜腫瘤。平均年齡由44.4歲增為51.9歲。肺癌及乳癌雙雙增加成為轉移性腫瘤最常見的來源。

關鍵字

脊椎脊髓腫瘤 ； 轉移性腫瘤 ； 統計分析 ； 台灣

並列摘要

The medical records of 117 patients with spinal tumors who underwent surgery with pathologic confirmation from January 1999 to April 2004 at Kaohsiung Medical University Hospital were reviewed. Data from this review were compared with those obtained from the same institution 10 years earlier (covering the period 1988-1995) and from other reported series. There were 69 male and 48 female patients aged from 13 to 87 years old (mean age, 51.9). The most common pathologic findings were metastasis in 45.3% (53/117), nerve sheath tumors in 28.2% (33/117), meningiomas in 12% (14/117) and neuroepithelial tumors in 6% (7/117). The peak ages at diagnosis were 41-50 years and 61-70 years. A slight male predominance was noted for all tumors, except meningiomas. Motor weakness, even paralysis, was the major clinical presentation (64-86%), followed by sensory deficits (50%) and pain (42%). The location of tumors was most often in the thoracic (50.4%; 59/117), lumbosacral (27.4%; 32/117) and cervical spine (22.2%; 26/117) segments. Among the metastatic tumors, the lung (22.6%) and breast (15.1%) were the most common primary sites of origin, followed by unknown origin, the liver (hepatocellular carcinoma), the gastrointestinal tract and the nasopharynx (nasopharyngeal cancer).

並列關鍵字

intraspinal tumor ； spinal metastasis ； statistics ； Taiwan