肺原发恶性纤维组织细胞瘤20例  

Primary Malignant Fibrous Histiocytoma of the Lung:A Report of 20 Cases

作　　者：黄崇标[1] 辛亮[1] 崔焱[1] 齐大亮[1] 

机构地区：[1]天津市肿瘤防治重点实验室,天津医科大学附属肿瘤医院高级病房,天津300060

出　　处：《中国肺癌杂志》2011年第5期414-417,共4页Chinese Journal of Lung Cancer

摘　　要：背景与目的肺原发恶性纤维组织细胞瘤是一种罕见的肿瘤。本文研究肺原发恶性纤维组织细胞瘤的临床特点及预后影响因素。方法回顾性分析肺原发恶性纤维组织细胞瘤20例的临床特点、治疗方式及生存情况等资料,采用SPSS16.0统计学软件,用Kaplan-Meier法及COX回归分析性别、肿瘤大小、肿瘤位置及化疗对术后生存期的影响。结果肺原发MFH的临床症状主要有咳嗽咳痰、痰中带血、胸痛、发热和胸闷。本组患者1年生存率为55.0%,2年生存率为25.0%,死亡原因多为局部复发及远处转移。肿瘤的大小和位置是肺原发MFH总生存率的独立预后因素。结论肺恶性纤维细胞瘤恶性程度高,预后差。临床治疗以手术为主,术后辅助化疗疗效尚不确切,肿瘤大小及位置和预后相关。Background and objective Primary malignant fibrous histiocytoma（MFH） of the lung is a type of rare sarcoma which showed a lack of detailed guidance about treatment and prognosis. The clinical features,treatment methods and prognosis of primary MFH of the lung were analyzed by this study to reveal some information of this disease. Methods The clinical data and survival state of 20 patients with primary pulmonary MFH treated in Cancer Institute and Hospital of Tianjin Medical University were collected. SPSS 16.0 software was used for statistical analysis. Kaplan-Meier method was applied to figure out whether gender,size,site and post-operative chemotherapy correlated to prognosis. COX regression was employed for multivariate prognostic analysis to find the unattached prognostic factors. Statistical significance was considered at P0.05. Results The clinical manifestations of primary pulmonary MFH mainly included cough,blood-stained sputum,chest pain,fever and chest distress. The one-year and two-year overall survival rates were 55.0% and 25.0%,respectively. Most cases died of local recurrence and distant metastasis. Multivariate COX regression analysis showed tumor size and location type were unattached prognostic factors. The patients with tumors smaller than 5 cm had a median survival of 27 months,while larger than 5 cm group＇s median survival was 8 months. The median survival of central tumor and the peripheral tumor were 6 months and 23 months respectively. Conclusion Primary pulmonary MFH was a type of highly malignant sarcoma which had poor prognosis. The main effective treatment was surgery,yet the role of postoperative adjuvant chemotherapy in the whole course of treatment was undefined. Small mass size and peripheral type might be correlated to relatively better prognosis.

关 键 词：恶性纤维组织细胞瘤 预后 多因素分析 

分 类 号：R734.2[医药卫生—肿瘤]