35例成人鼻腔鼻窦横纹肌肉瘤临床分析  

Clinical analysis of 35 cases of adult rhabdomyosarcoma of nasal cavity and sinuses

作　　者：李笑秋 彭金林 刘柱 崔哲卿 张普文 金红军[1] LI Xiaoqiu;PENG Jinlin;LIU Zhu;CUI Zheqing;ZHANG Puwen;JIN Hongjun(Department of Rhinology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China;Department of Otolaryngology,Zhengzhou Central Hospital)

机构地区：[1]郑州大学第一附属医院鼻科,郑州450052 [2]郑州市中心医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2020年第3期223-226,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨成人鼻腔鼻窦横纹肌肉瘤(RMS)的临床特点及影响预后的因素。方法:成人鼻腔鼻窦RMS患者35例,其中胚胎型22例,腺泡型13例。手术+放化疗17例,手术+放疗6例,手术+化疗7例(手术及化疗后粒子植入4例);5例未行手术治疗,仅用抗肿瘤药物治疗。结果:随访9~62个月,成人鼻腔鼻窦RMS 5年总生存率为2.9%,其中IRS分期>Ⅱ期、肿瘤颅底浸润、局部淋巴结转移、肿瘤直径≥5 cm、Ki-67≥50%是预后不良因素。结论:成人鼻腔鼻窦RMS以胚胎型多见,5年总生存率低,与成人初诊时原发灶肿瘤体积较大、局部淋巴结转移、颅底浸润、Ki-67占比较高等有关。Objective: To investigate the clinical characteristics and prognostic factors of adult rhabdomyosarcoma(RMS) of nasal cavity and sinus. Method: There were 35 adult patients with RMS, including 22 with embryonal type and 13 with acinar type. Surgery + chemoradiotherapy(17 cases), surgery + radiotherapy(6 cases), surgery + chemotherapy(7 cases)(4 cases of seed implantation after surgery and chemotherapy);Five patients were treated with antitumor drugs instead of surgery. Result: The study follow-up 9-62 months, adult nasal sinuses RMS total 5 years survival rate was 2.9%, among them the IRS stage>Ⅱ period, the infiltration of the skull base tumor, local lymph node metastasis, tumor diameter of 5 cm or more, 50% or higher Ki-67 are poor prognosis factor. Conclusion: RMS in nasal cavity and sinus are mostly embryonal type in adults, and the 5-year overall survival rate is low, which is related to larger primary tumor volume, local lymph node metastasis, skull base infiltration and higher ki-67 ratio at the first diagnosis in adults.

关 键 词：横纹肌肉瘤 鼻腔鼻窦 成人 

分 类 号：R739.62[医药卫生—肿瘤]