The Relativity Analysis Of Clinical Characteristics And Pathology Of Glioma In The Different Part Of Intracalvarium

Glioma, also be called the neurogliocytoma, which is a familiar malignant brain tumor, the morbility is about 12/100000, and gliomas constituted about 35.2~61% of all primary intracranial tumors, the average is about 44.69%, the abroad is similar to this comparison, with high morbidity, high recurrence rate, high mortality rates and low cure rate of the"three highs and one low"characteristics. Origin of glioma is the neuroepithelial cells in general, in the nervous system tumor classification of WHO2000 year, the tumors of neuroepithelial tissue are classified ten types, but in the narrow sense the origin of glioma is the gliacytes in histopathology. Glioma mainly include astrocytic tumors, oligodendrocyte tumors, mixed glioma, ependymal tumors, medulloblastoma, etc. Glioma can take place in any age, the predilection age of is 30~40 years old and 10~20 years old. The glioma can be distribute in the each district of the brain, but the dissimilar pathology of glioma have the diverse predilection site, for example, the predilection sites of astrocytoma are cerebral hemisphere, thalamus and basal ganglia in adult, the predilection sites of astrocytoma are cerebellar hemisphere and fourth ventricle in child. The predilection site of medulloblastoma is vermis cerebellum.The predilection site of ependymoma is ventricular systems. The main clinical manifestations are intracranial hypertension and focal nervous functional impairment. The former mainly includes the headache, nauseated, vomit and papilledema, etc. the latter mainly includes epilepsy, anepia, hemiplegia, smell hallucination, alternate hemiplegia, etc. The growth pattern of glioma is invasive, so the glioma and the surrounding normal brain tissue are not defined. Glioma often violate the important functional areas, so complete surgical resection of tumor tissue is rather difficult.Because the gliacytes average cell period is only 3.5 days, glioma will recur quickly if only through surgical treatment, so currently the treatment of glioma is often integrated. Surgical treatment is the first choice for treatment, radiotherapy, chemotherapy and biotherapy as surgical aids. Life span can be obviously extended through the adjunctive therapy. According to the statistics, the survival rate of astrocytoma (Ⅰ~Ⅱclass) of 1, 3, 5years distinguishes to 100.0%, 87.7%, 58.2% and astrocytoma (Ⅲ~Ⅳc lass) of 1, 3, 5years distinguishes to 80.0%, 35.0%, 2.5% through the above-mentioned treatments. The prognosis of the malignant glioma and deep site of glioma is still not very optimistic. The prognosis of glioma have close relation with the pathologic type, rating and treatment perscription. The clinical research expresses that the pathologic type and the age factor have certain regulation, because of the pathologic type different, its predilection age is also different. The pathologic type and genetic locus have certain regulation, the pathologic type is dissimilar, its predilection site is also different. The genetic locus and clinical manifestation are close related, the different genetic locus of gliomas have different clinical manifestations. The clinical manifestations include common symptoms and local symptoms. The pathologic type and clinical manifestations have no regulation to follow.Objective: To investigate the characteristics and regulations of the intracal glioma between the age distribution, genetic locus distribution, the clinical manifestations of the different site, and the clinical manifestations of the different pathologic type.Methods: Collecting the clinical data with complete clinical information from 285 cases of gliomas in the First Hospital of Jilin University neurosurgery from March 2004 to March 2008. All the patients are diagnosed via surgical operation and the final diagnosis were based on the standard of pathology. There are 155 male, 130 female, the comparison of male/female is 1.19: 1, and the age ranged from 1 to 79 years old (average 40.7±2.6 years old). Through retrospective analysis of the intracal gliomas between the age distribution, genetic locus distribution, the clinical manifestations of the different part, and the clinical manifestations of the different pathologic type, analyze the compose of each different item, to observe the characteristics and regulations of these items. The important points carry outχ~2 test with statistic software SPSS 15.0 to see whether there is statistics significance.Result:1,This clinical data manifest the predilection age of gliomas is 31~50 years old. The predilection age of astrocytoma is 31~60 years old. The predilection age of oligodendroglioma is 31~50 years old. The predilection age of ependymoma is 21~40 years old. The predilection age of mixed glioma is 31~50 years old. All of the medulloblastoma is under 30 years old.2,This clinical data show that in 285 gliomas cases, there are 230 cases occur supratentorial and 55 cases occur infratentorial, so the comparison of supratentorial/infratentorial is 4.18: 1. The predilection pathologic type is astrocytoma, mixed glioma, ependymoma, oligodendroglioma of supratentorial glioma in orders. There is no medulloblastoma in supratentorium. The predilection pathologic type is ependymoma, astrocytoma, mixed glioma, oligodendroglioma of lateral cerebral ventricle in orders. The predilection pathologic type is medulloblastoma, astrocytoma, ependymoma of infratentorial gliomas in orders. The mixed glioma and oligodendroglioma occur infratentorium is very few. The predilection pathologic type is ependymoma, medulloblastoma, astrocytoma of fourth ventricle in orders.The predilection site of astrocytoma is temporal lobe, multilobe, frontal lobe, apical lobe, cerebellar hemisphere in orders. The predilection site of mixed glioma is frontal lobe, multilobe, temporal lobe, lateral cerebral ventricle in orders. The predilection site of ependymoma is fourth ventricle, lateral cerebral ventricle in orders. The predilection site of medulloblastoma is vermis cerebellum, cerebellar hemisphere, fourth ventricle in orders. The predilection site of oligodendroglioma is frontal lobe, lateral cerebral ventricle, temporal lobe in orders.3,The common clinical manifestation is intracranial hypertension, the next is dyskinesia and epilepsy. Almost all sites of gliomas appear intracranial hypertension symptom. The predilection site of epilepsy is frontal lobe, multilobe, temporal lobe, apical lobe, occipital lobe in orders. The predilection site of dyskinesia is multilobe, frontal lobe, temporal lobe in orders. The predilection site of allolalia is multilobe, temporal lobe, frontal lobe in orders. The predilection site of sensory disability is temporal lobe, multilobe in orders. There are 2 cases occur smell hallucination, both take place in temporal lobe. The cerebellar hemisphere and vermis cerebellum predilection symptom is ataxia and nystagmus in orders. The cerebellopontine angle symptom include sensory disability,tinnitus,facioplegia, nystagmus and ataxia, etc.4,This clinical data show that clinical manifestation depends on the site of the tumor, it is hard to tell the pathologic type of gliomas only by clinical manifestations. It is well worth mentioning is that morbidity of epilepsy is 64.29% in oligodendroglioma in this clinical data. The morbidity is the first place in tumors of neuroepithelial tissue, and is the first symptom in most of the patients.Conclusion:1,The pathologic type and the age factor are close related, because of the pathologic type different, its predilection age is also different.2,The pathologic type and genetic locus are close related, the pathologic type is dissimilar, its predilection site is also different.3,The genetic locus and clinical manifestation are close related, the different genetic locus of gliomas have different clinical manifestations. The clinical manifestations include common symptoms and local symptoms.4,The pathologic type and clinical manifestations have no regulation to follow.