60例韧带样型纤维瘤病临床病理特点及预后分析  

The Clinical Characteristics and Prognostic Factors of Desmoid-type Fibromatoses in 60 Patients

作　　者：杨力[1] 扈文海[1] 胡彤宇[1] 齐典文[1] 张国川[1] 

机构地区：[1]河北医科大学第三医院骨与软组织肿瘤科,河北石家庄050051

出　　处：《实用骨科杂志》2015年第1期30-32,53,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨韧带样型纤维瘤病临床、影像学及病理特点,为临床诊治及预后提供依据。方法收集2002年1月至2013年12月经本院收治的60例韧带样型纤维瘤患者的临床资料,其中男26例,女34例,男女比例1︰1.3。患者年龄8个月-55岁,中位年龄25岁。发病部位位于臀部25例,肩部5例,背部4例,上肢4例,手4例,足部4例,颈部3例,腹部2例,锁骨部位2例,胸壁2例,肘部2例,髂窝1例,小腿2例。60例患者均接受了手术治疗,33例复发患者均行扩大或广泛切除术,其中1例行右上肢截肢术,其余27例初治患者20例行扩大切除术,7例行边缘切除术。结果 27例原发初治患者,2例术后复发。33例复发再治患者,8例复发,以上均未见转移。结论韧带样型纤维瘤病是一种临床表现以肢体局部疼痛、质硬肿块为特点,病理以浸润侵袭周围正常组织为特征的罕见良性肿瘤。肿瘤切缘阳性或边缘性切除是导致肿瘤复发的重要原因,无论是原发还是复发韧带样纤维瘤患者,都应在保全肢体功能的情况下,争取做到扩大切除或广泛切除时,在无法保证肿瘤完整切除时,应进行术后放疗的进一步治疗并密切随访。Objective To investigate the clinicopathologic features, prognostic study and pathologic feature of desmoid- type fibromatoses and provide the basis for clinical treatment and prognosis. Methods The records of 60 patients with desmoid-type fibromatoses treated at our hospital between 2002.1 and 2013.12 were reviewed. They were 26 males and 34 females in this group（male/female = 1/1.3）. They were aged from 8 months to 55 years with an median ages of 25. Tumor were located at hips in 25 ; shouders in 5 ; back in 4 ; upper limb in 4 ; hands in 4 ; loots in 4 ; neck in 3 ; abdomen in 2 ; clavicle region in 2;chest in 2;elbow in 2;fossa iliac in 1 ;shank in 2. All 60 patients were under surgery treatment,33 patients with recurrence are expanding or wide resection, 1 of whom underwent right upper limb amputation, the rest of the 27 patients treated first 20 patients underwent resection of the expansion,7 patients underwent resection of the edge. Results 2 cases of postoperative recurrence in 27 patients with primary treated first, To cure patients, 33 recurrence after our extended resection or wide resection, 8 cases of recurrence, the above transfer was not found. Conclusion Ligament type fibromatosis is a body to local pain, qualitative characteristics of hard lump, the pathological characteristics of infiltration, invade surrounding normal tissues is a rare benign tumor. Cut edge positive or borderline tumor resection is the important cause of tumor recurrence ,both primary and recurrent ligament tumor patients, should be in the security under the condition of limb function, we should try to be extended resection or wide excision, in there is no guarantee that complete tumor resection, should carry on the further treatment of postoperative radiation therapy and follow-up closely.

关 键 词：韧带样型纤维瘤病 病理特点 手术治疗 预后 

分 类 号：R738.7[医药卫生—肿瘤]