盆腔孤立性纤维瘤的临床诊治特点及预后分析  

Clinical characteristics and prognosis of pelvic solitary fibrous tumors

作　　者：牟怡平[1] 党富平 王瑞涛[2] 王曙逢[3] 侯惠莲[4] MU Yiping;DANG Fuping;WANG Ruitao;WANG Shufeng;HOU Huilian(The Medical Information Management Office,the First Affiliated Hospital of Xi'an Jiaotong Universi-ty,Xi'an,Shaanxi 710061,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi'an Jiaotong Universi-ty,Xi'an,Shaanxi 710061,China;Department of General Surgery,the First Affiliated Hospital of Xi'an Jiaotong Universi-ty,Xi'an,Shaanxi 710061,China;Department of Pathology,the First Affiliated Hospital of Xi'an Jiaotong Universi-ty,Xi'an,Shaanxi 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普外科,陕西西安710061 [4]西安交通大学第一附属医院病理科,陕西西安710061

出　　处：《安徽医药》2022年第11期2240-2243,I0003,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨盆腔孤立性纤维瘤(solitary fibrous tumor,SFT)临床病理特点、诊治现状及预后。方法复习国内外文献,回顾性分析2010年1月至2019年7月西安交通大学第一附属医院5例经手术切除及病理确诊为盆腔SFT的病人病例资料,采用HE和免疫组织化学SP法检测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5例SFT病人平均年龄54岁,分别发生于腹膜后、骶前、膀胱等盆腔位置。早期SFT病人无任何典型临床表现,随着肿瘤体积增大,病灶局部逐渐出现肿块压迫症状。大体标本组织学示肿瘤内为伴血管外皮瘤样和黏液样变性的成束梭形细胞,其间隔不同范围的胶原纤维。免疫组化染色结果:Vim阳性率100%(5/5)、CD34100%(5/5)、CD9980%(4/5)、Ki-6760%(3/5)、bcl-260%(3/5)、S-100、SMA、Des、NSE均为20%(1/5)。均获有效随访,平均随访37.4个月,均无复发及转移。结论作为一种特殊且少见的梭形细胞肿瘤,SFT的常规影像学和实验室检查特异性均较低,临床诊断需结合病理和免疫组化结果进行,根治性切除为首选治疗方法,也是影响SFT预后的最重要因素。Objective Combined with clinical cases and literature reports,the clinicopathological features,diagnosis and treatment status and prognosis of pelvic solitary fibrous tumors(SFTs)were discussed.Methods Reviewing domestic and foreign literature,we retrospectively analyzed the case data of 5 patients with pelvic SFT diagnosed by surgical resection and pathology from January 2010 to July 2019 in the First Affiliated Hospital of Xi’an Jiaotong University.HE and immunohistochemical SP methods were used to detect Vim,CD34,CD99,Ki-67,bcl-2 and S-100 expression,and their clinicopathological characteristics and prognosis were analyzed.Results The average age of the 5 SFT patients was 54 years,and they occurred in the retroperitoneum,presacral,bladder and other pelvic locations.Early SFT patients do not have any typical clinical manifestations.With the increase in tumor volume,local tumor compression symptoms gradually appear.Gross specimen histology revealed bundles of spindle cells with hemangiopericytoma-like and myxoid degeneration within the tumor,separated by various ranges of collagen fibers.Immunohistochemical staining results:Vim positive rate 100%(5/5),CD34100%(5/5),CD9980%(4/5),Ki-6760%(3/5),bcl-260%(3/5),S-100,SMA,Des,and NSE were all 20%(1/5).All patients were effectively followed up,with an average follow-up of 37.4 months,and there was no recurrence or metastasis.Conclusion As a special and rare spindle cell tumor,the specificity of routine imaging and laboratory tests for SFT is low.The clinical diagnosis needs to be combined with the results of pathology and immunohistochemistry.Radical resection is the preferred treatment method,which also affects SFT.the most important prognostic factor.

关 键 词：孤立性纤维瘤 盆腔占位病变 抗原 CD34 抗原类 CD99 基因 bcl-2 免疫组织化学染色 预后分析 

分 类 号：R737[医药卫生—肿瘤]