胸部侵袭性纤维瘤病的临床特征和外科治疗效果  

Clinical features and surgical treatment of chest aggressive fibromatosis

作　　者：张艳娇[1] 高禹舜[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院胸外科,100021

出　　处：《中华肿瘤杂志》2016年第3期232-235,共4页Chinese Journal of Oncology

摘　　要：目的分析胸部侵袭性纤维瘤病的临床特点和外科治疗效果。方法回顾性分析1998年9月至2014年5月中国医学科学院肿瘤医院胸外科收治的25例胸部侵袭性纤维瘤病患者的临床资料。结果25例胸部侵袭性纤维瘤病患者中，男12例，女13例；年龄15—76岁，平均年龄38岁。首发症状为胸背部疼痛9例（36．0％），气短1例（4．0％），体检发现13例（52．0％），2例患者因肺部疾病手术时发现病变（8．0％）。肿瘤位于左胸壁15例，右胸壁10例，其中最常见的好发部位为左前上胸壁和右前上胸壁。影像学、穿刺病理结果均不能明确诊断，确诊需经术后病理和免疫组化检查。25例患者中，行肿物切除术13例，行姑息性切除术3例，行扩大切除术9例；6例患者术后进行放射治疗。中位随访101．5个月，25例患者均生存，5例患者复发，其中4例为行肿物切除术的患者，1例为行扩大切除术的患者。结论侵袭性纤维瘤病是一种低度恶性肿瘤，诊断需经病理及免疫组化检查；侵袭性纤维瘤病虽易复发，但预后较好，手术根治性切除是患者获得生存质量和长期生存的重要方法。Objective To investigate the clinical features and surgical treatment of chest aggressive fibromatosis. Methods Twenty-five patients with aggressive fibromatosis treated from September 1998 to May 2014 in the Department of Thoracic Surgery of Cancer Hospital of Chinese Academy of Medical Sciences were included in this study. Results The 25 patients, including 12 males and 13 famales, had an average age of 38 （ range 15-76 years）. The initial manifestations included chest pain （ 9 patients, 36.0% ） and shortness of breath （ 1 patient）. In 13 patients （ 52.0% ） the tumor was found in a physical examination. Two patients （8.0%） were detected during an operation for lung disease. The tumor was located in the left chest wall in 15 patients, and located on the right side in 10 patients. Among them, the most common locations were the left front chest wall and the right front chest wall. The operation method affects the prognosis. Radiological imaging and needle biopsy did not make a correct diagnosis, and the diagnosis of aggressive fibromatosis was confirmed by pathology using immunohistechmistry after surgery. 13 patients underwent tumor resection, 9 cases had expanded resection, 3 patients had palliative resection. Six cases received radiotherapy after surgery. The median follow-up time was 101.5 months. Currently, all of the 25 patients are still alive, but 5 cases had local recurrence after surgery, among them, 4 patients received tumor resection, and one patient underwent expanded resection. Conclusions Aggressive fibromatosis is a low-grade malignant tumor. The diagnosis of aggressive fibromatosis needs to he confirmed by pathology using immunohistechmical staining after surgery. Although this tumor is liable to relapse, its prognosis is favorable. Radical surgery is the most important treatment for patients to get a higher quality of life and long-term survival without recurrence.

关 键 词：胸部肿瘤 侵袭性纤维瘤病 外科手术 预后 

分 类 号：R730.56[医药卫生—肿瘤]