Nojima Takayuki
Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa pref. 920-0293, Japan.
Rinsho Byori. 2010 Apr;58(4):352-7.
Soft tissue sarcomas are rare malignant tumors arising from soft tissues of mesenchymal origin. These tumors can develop from any site in the body, including the extremities, trunk, retroperitoneum, and the head and neck. Factors such as histologic subtype and grade, as well as patient age, tumor size, location and clinical stage, determine the specific approach to management and patient outcome. Early detection and treatment based on accurate diagnosis are the basic principles of the management of soft tissue sarcomas. Although the histological grading of soft tissue sarcomas is based on the French Federation Nationale des Lutte Contre le Cancer (FNCLCC) system, it seems to easy to use the histological grading based on the MIB-1 labeling index. The definitive diagnosis of soft tissue tumors is aided by appropriate immunohistochemical examination and molecular analysis. In particularly, molecular analysis of tumor-specific chromosomal translocations using FISH or RT-PCR methods offers a useful adjunct to the accurate diagnosis of soft tissue tumors. However, many studies have indicated a growing number of fusion gene variations in each tumor type. This article reviews and discusses problems in the diagnostic pathology of soft tissue tumors with newly useful pathological methods.
软组织肉瘤是起源于间充质来源软组织的罕见恶性肿瘤。这些肿瘤可发生于身体的任何部位,包括四肢、躯干、腹膜后以及头颈部。组织学亚型和分级、患者年龄、肿瘤大小、位置及临床分期等因素决定了具体的治疗方法和患者预后。基于准确诊断的早期检测和治疗是软组织肉瘤治疗的基本原则。虽然软组织肉瘤的组织学分级基于法国国立癌症防治联盟(FNCLCC)系统,但似乎使用基于MIB-1标记指数的组织学分级更容易。适当的免疫组织化学检查和分子分析有助于软组织肿瘤的明确诊断。特别是,使用荧光原位杂交(FISH)或逆转录聚合酶链反应(RT-PCR)方法对肿瘤特异性染色体易位进行分子分析,为软组织肿瘤的准确诊断提供了有用的辅助手段。然而,许多研究表明每种肿瘤类型中融合基因变异的数量在不断增加。本文用新的有用的病理方法回顾并讨论软组织肿瘤诊断病理学中的问题。