1型和2型神经纤维瘤病的治疗进展

G. Popescu, Francesca Paslaru, M.C. Zaharia, M. Popescu, R.M. Gorgan
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摘要

背景:1型神经纤维瘤病(NF1)和2型神经纤维瘤病(NF2)是罕见的肿瘤抑制综合征,由肿瘤抑制基因(TSG)的异常突变引发(1)。这些综合征中的每一种都是孤儿病(本身),但在这些患者中遇到的肿瘤是最常见的神经系统病变。在这两种疾病中,NF1表现出更大的恶性肿瘤风险,因此准确诊断和区分这两种病理实体非常重要。本文的目的是描述我科治疗神经纤维瘤病的实践方案,并回顾目前有关这些复杂疾病的临床诊断和治疗的文献。方法:回顾性分析2011年至2018年在我院治疗的25例神经纤维瘤病患者。结果:女性16例(64%),男性9例(36%)。平均发病年龄为48.7岁(14-72岁)。NF1 7例(28%),NF2 18例(72%)。家族史阳性7例(28%),无家族史18例(72%)。最常见的症状是听力丧失、眩晕和头痛。结论:神经纤维瘤病是一种非常复杂的疾病,肿瘤可能具有不可预见的生长模式。新的肿瘤会在数年内生长,而且症状难以预测。手术治疗最好留给有症状的肿瘤。非手术治疗也是治疗的重要步骤,但需要进一步的研究来确定其有效性。
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Therapeutic advances in treatment of patients with neurofibromatosis type 1 and type 2
Background: Neurofibromatosis type 1 (NF1) and neurofibromatosis type 2 (NF2) are rare tumoral suppressor syndromes, triggered by an abnormal mutation in a tumour suppressor gene (TSG) (1). Each of these syndromes represents an orphan disease (by itself), but the tumours encountered in these patients are the most frequent lesions of the nervous system. Between the two of these diseases, NF1 presents a greater risk of malignancy, hence the importance of an accurate diagnosis and distinction between the two pathological entities. The purpose of this paper is to describe our department's practice protocol with neurofibromatosis and review the current literature regarding clinical diagnosis and management of these complex diseases. Methods: Our paper is a retrospective study that comprehends 25 patients with neurofibromatosis treated in our clinic between 2011 and 2018. Results: Our study included 16 female patients (64%) and 9 male patients (36%). The mean age at presentation was 48,7 (range 14-72 years). There were 7 cases (28%) of NF1 and 18 cases (72%) of NF2. Seven cases (28%) had a positive family history and 18 patients did not (72%). The most common symptoms at presentation were hearing loss, vertigo, and headache. Conclusions: Neurofibromatosis is a very complex disease in which the tumours may have an unforeseeable growth pattern. New tumours can grow over the years and the symptoms are unpredictable. Surgical treatment is best to be reserved for symptomatic tumours. Non-surgical procedures are also an important step of the treatment, but further studies are required to decide their effectiveness.
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