腹膜后孤立性纤维瘤的临床特点及预后分析  

Clinical characteristics and prognosis of solitary fibrous tumor in the retroperitoneum

作　　者：牟怡平[1] 王瑞涛[2] 侯惠莲[3] 刘昌[2] MU Yiping;WANG Ruitao;HOU Huilian;LIU Chang(Medical Information Management Office, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061;Department of Hepatobiliary Surgery,The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061;Department of Pathology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China)

机构地区：[1]西安交通大学第一附属医院医疗信息管理办公室,陕西西安710061 [2]西安交通大学第一附属医院肝胆外科,陕西西安710061 [3]西安交通大学第一附属医院病理科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2021年第1期81-85,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的探讨腹膜后孤立性纤维瘤(SFT)的临床病理特点及预后。方法分析西安交通大学第一附属医院2007年1月至2017年12月间收治的9例手术切除并行病理检查确诊为SFT的临床及预后资料,采用HE和免疫组织化学SP法检测9例腹膜后SFT肿瘤细胞Vimintin(Vim)、CD34、CD99、Ki-67、Bcl-2和S-100的表达,分析其临床病理特点及预后。结果9例中,男性4例,女性5例,年龄37~69岁,5例表现为腹胀,4例无明显临床症状,肿瘤大小(1.0 cm×1.0 cm×2.0 cm)~(30.0 cm×25.0 cm×10.0 cm),单发7例,多发2例。组织学表现为束状、编织状排列的梭形细胞和不同程度的胶原纤维,伴有黏液变性及血管外皮瘤样形态。免疫组化阳性率结果:Vim、CD34、CD99100%(9/9),Ki-6777%(7/9)、Bcl-267%(6/9)、S-10022%(2/9)。均获有效随访,2例死亡,均与研究疾病不相关,术后存活时间分别为6.5、8.3年,存活病例中有1例在术后3年复发,二次手术后未再复发,其余病例均未见复发转移。结论腹膜后SFT临床少见,早期无典型临床症状,多于查体发现,超声、CT检查是主要术前检查方法,但对SFT诊断无特异性,根治性切除是治疗首选,病理检查是确诊的唯一方法,早期行根治性手术治疗及术后定期复查的疗效确切。Objective To investigate the clinicopathological characteristics and prognosis of solitary fibrous tumor(SFT)in the retroperitoneum.Methods We summarized the clinical and prognostic data of nine patients admitted to The First Affiliated Hospital of Xi’an Jiaotong University between January 2007 and December 2017 who were diagnosed with SFT by surgical resection and pathological examination.Nine cases of retroperitoneal SFT were detected by HE and immunohistochemical SP method.The expressions of Vimintin(Vim),CD34,CD99,Ki-67,Bcl-2 and S-100 in tumor cells were analyzed for their clinicopathological characteristics and prognosis.Results Among the nine patients,four were male and five were female,aged 37-69 years old.Five of them showed abdominal distension,while the other four had no obvious clinical symptoms.The tumor size was(1.0 cm×1.0 cm×2.0 cm)-(30.0 cm×25.0 cm×10.0 cm).There were seven single cases and two multiple cases.Histology showed bundle-shaped,braided spindle cells and collagen fibers of varying degrees,accompanied by mucinous degeneration and hemangiopericytoma-like morphology.Immunohistochemical results were as follows:The positive rate was 100%(9/9)for Vim,CD34 and CD99,77%(7/9)for Ki-67,67%(6/9)for Bcl-2,and 22%(2/9)for S-100.All the patients were followed up effectively.Two of them died(the cause of death was not related to the disease studied,and the survival time from postoperative to death was 6.5 years and 8.3 years,respectively).One surviving case relapsed 3 years after the operation,but did not recur after the second operation.No recurrence or metastasis was found in the remaining cases.Conclusion Retroperitoneal SFT is rare in the clinic,and there areno typical clinical symptoms in the early stage.Most of them are detected in physical check-ups.Ultrasound and CT examinations are the main preoperative examination methods,but they are not specific to SFT.Pathological examination is the only method for diagnosis.Radical resection is the first-choice of treatment.The preferred method for

关 键 词：腹膜后孤立性纤维瘤 临床病理特征 预后分析 

分 类 号：R735.4[医药卫生—肿瘤]