中枢神经系统孤立性纤维瘤的临床分析  

Clinical analysis of solitary fibrous tumors in central nervous system

作　　者：舒凯[1] 赵恺[1] 蒋伟[1] 陈劲草[1] 陈坚[1] 柯昌庶[2] 雷霆[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,武汉430030 [2]华中科技大学同济医学院附属同济医院病理科,武汉430030

出　　处：《中华神经外科杂志》2016年第11期1122-1125,共4页Chinese Journal of Neurosurgery

基　　金：武汉市科技攻关计划（20130605010154）

摘　　要：目的探讨中枢神经系统孤立性纤维瘤的临床特点、病理学表现以及治疗效果，以提高孤立性纤维瘤的诊断和治疗。方法回顾性分析2010年5月至2015年8月在华中科技大学同济医学院附属同济医院神经外科手术治疗并经病理证实为中枢神经系统孤立性纤维瘤的27例患者的临床资料。结果27例经显微手术治疗的中枢神经系统孤立性纤维瘤患者中，肿瘤全切除21例，次全切除5例，1例活检。病理学诊断为良性23例，恶性4例。免疫组织化学检查显示：CD34呈弥漫阳性21例（78％）、局灶阳性6例（22％）；Vimentin阳性21例（78％）。所有患者平均随访38个月，肿瘤全切除者预后较好，次全切者原位复发。结论中枢神经系统孤立性纤维瘤临床表现和影像学检查易误诊，确诊需要病理学检查，手术切除是确切有效的治疗方法，全切除患者预后良好。Objective To investigate the clinical characteristics, pathologic manifestation and treatment effect of solitary fibrous tumor （SFT） in central nervous system （CNS） in order to improve the diagnosis and treatment of SFT. Methods From May 2010 to August 2015, the clinical data of 27 patients with solitary fibrous tumors in central nervous system operated and confirmed by pathology at the Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were analyzed retrospectively. Results In 27 patients with SFT treated with microsurgery, 21 received total tumor resection, 5 had subtotal resection, and 1 performed biopsy. Twenty-three patients were diagnosed as benign and 4 were diagnosed as malignant with pathological diagnosis. Immunohistochemical examination showed that 21 （78%） were CD34 diffuse positive, 6 （22%） were focal positive, and 21 （78%） were Vimentin positive. All patients were followed up for 38 months. The prognosis of patients with total tumor resection was better; the patients of subtotal resection had in situ recurrence. Conclusions The clinical manifestation and imaging examination of SFT in central nervous system are easy to be misdiagnosed. The diagnosis requires pathological and immunohistochemical examinations. Surgical resection is the exact and effective treatment. The prognosis of patients with total resection is good.

关 键 词：中枢神经系统肿瘤 孤立性纤维瘤 病理学 治疗结果 

分 类 号：R739.4[医药卫生—肿瘤]