颅内孤立性纤维性肿瘤/血管周细胞瘤的临床特点及复发影响因素分析  

Clinicopathological analysis on intracranial solitary fibrous tumor/hemangiopericytoma

作　　者：徐宏浩 黄庆玖[2] 陈永严[2] 刘翔[2] 杨坤[2] 胡新华[2] 张锐[1] 张玉海[2] XU Hong-hao;HUANG Qing-jiu;CHEN Yong-yan(Department of Functional Neurosurgery, the Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学附属脑科医院功能神经外科,南京210029 [2]南京医科大学附属脑科医院神经外科,南京210029

出　　处：《临床神经外科杂志》2020年第6期680-684,共5页Journal of Clinical Neurosurgery

摘　　要：目的探讨颅内孤立性纤维性肿瘤/血管周细胞瘤(SFT/HPC)的临床特点、治疗方法及复发的影响因素。方法回顾性分析19例颅内SFT/HPC患者的临床资料。结果本组患者中,男10例,女9例,年龄18~71岁,平均年龄(49.5±13.9)岁,中位年龄50岁;病程数天至2年;均行显微手术切除肿瘤。术后头颅CT或MRI复查显示,16例患者肿瘤全切除,3例患者肿瘤次全切除。13例患者获得随访,随访时间为6~132个月,平均为(46.0±37.9)个月,其中6例患者复发,复发时间为术后60~79个月,平均(72.0±7.1)个月;无患者发生颅外及颅内远隔部位转移。至最后随访时,肿瘤全切除患者的复发率为36.4%,次全切除患者的复发率为100%,两组复发率间的差异有统计学意义(P<0.05);术后辅助放疗患者的复发率为20%,未放疗患者的复发率为33.3%,两组复发率间的差异无统计学意义(P>0.05)。结论颅内SFT/HPC临床少见、病程较短;手术是其主要的治疗手段,近期效果良好,而远期复发率较高;肿瘤全切除可明显减少术后复发率;术后放疗对复发率的影响有待进一步研究。Objective To investigate the clinical manifestations,therapies and prognostic factors of intracranial solitary fibrous tumor/hemangiopericytoma(SFT/HPC).Methods The clinical data of 19 patients with intracranial SFT/HPC were retrospectively analyzed.Results In the study,there were 10 male and 9 female patients ranged from 18 to 71 years old(mean 49.5±13.9 years and median 59 years)were recruited.The duration of the patients'disease ranged from days to 2 years.All patients underwent microsurgical treatment.Postoperative CT or MRI examination of the head showed total tumor resection in 16 patients and subtotal tumor resection in 3 patients.13 patients were follow-up for 6-132 months,with an average of 46.0±37.9 months.The recurrence time of 6 patients was 60-79 months after surgery,72.0±7.1 months on average.No patients had extracranial or intracranial distant metastasis.At the final follow-up,the recurrence rate of patients with total tumor resection was 36.4%and that of patients with subtotal tumor resection was 100%,and the difference between the two groups was statistically significant(P<0.05).The recurrence rate of postoperative adjuvant radiotherapy patients was 20%,and that of non-radiotherapy patients was 33.3%,the difference between the two groups was not statistically significant(P>0.05).Conclusions Intracranial SFT/HPC is a rare entity with short course duration.Surgery is the primary option.Short-term control is favorable while long-term recurrent rate is still high.Total tumor resection can significantly reduce postoperative recurrence rate.The effects of postoperative radiotherapy on recurrence rate needs further study.

关 键 词：孤立性纤维性肿瘤/血管周细胞瘤 临床表现 显微手术 放射治疗 复发 

分 类 号：R739.41[医药卫生—肿瘤]