[上肢腱鞘巨细胞瘤复发相关因素分析]

Liu Yang-Bo, Lin Ding-Sheng, Wang Jian, Zhang Huai-Bao, Chen Lei

Department of Orthopaedics, the First Hospital Affiliated to Whenzhou Medical College, Wenzhou 325000, Zhejiang, China.

Zhongguo Gu Shang. 2011 Dec;24(12):988-91.

OBJECTIVE

To study the relation of the sex, age, location and chemotherapy with recurrence of the tumor.

METHODS

From January 2000 to August 2010, 47 patients with giant cell tumor of tendon sheath in upper extremity were retrospectively analyzed. Statistical analysis of sex, age at presentation, lesion location, chemical inactivation, surgical complications, tumor recurrence and pathological findings were explored. There were 28 females and 19 males, ranging in age from 17 to 78 years, with an average of 38.15 years. All the patients underwent surgical excision. Fourteen patients received intraoperative chemically inactive treatment. All the patients had routine follow-up to observe the wound healing, pathological findings,tumor recurrence, and received necessary imaging examinations.

RESULTS

All the patients were followed up, and the duration ranged from 22 to 129 months, with a mean time of 53.89 months. Four patients who received intraoperative alcohol inactivation appeared wound complications such as wound swelling, discharge of necrotic tissue, delayed wound healing. Fifteen patients had active growth of tumor tissue, 1 patient had low-grade malignant giant cell tumor of tendon sheath. The recurrence rate was significantly higher in the group which preoperative X-ray was found to have bone destruction (P = 0.003); patients receiving chemically inactivation had lower risk of recurrence after surgery than patients not receiving chemically inactivation (P = 0.042).

CONCLUSION

The recurrence rate of giant cell tumor of tendon sheath in upper limb was closely related to tumor growth site, bone destruction and chemical inactivation. Local excision of giant cell tumor of tendon sheath was the effective treatment. How to identify the patients at high risk of recurrence, how to reduce the recurrence rate and the functional restoration after wide resection are the priorities and difficulties of future researches.

目的

研究肿瘤复发与性别、年龄、部位及化疗的关系。

方法

回顾性分析2000年1月至2010年8月间47例上肢腱鞘巨细胞瘤患者。对患者的性别、就诊年龄、病变部位、化学灭活、手术并发症、肿瘤复发及病理结果进行统计学分析。其中女性28例，男性19例，年龄17～78岁，平均38.15岁。所有患者均接受手术切除。14例患者术中接受化学灭活治疗。所有患者均进行常规随访，观察伤口愈合情况、病理结果、肿瘤复发情况，并接受必要的影像学检查。

结果

所有患者均获随访，随访时间22～129个月，平均53.89个月。4例术中接受酒精灭活的患者出现伤口并发症，如伤口肿胀、坏死组织排出、伤口愈合延迟。15例患者肿瘤组织呈活跃生长，1例为低度恶性腱鞘巨细胞瘤。术前X线检查发现有骨质破坏的患者复发率明显更高（P = 0.003）；接受化学灭活的患者术后复发风险低于未接受化学灭活的患者（P = 0.042）。