Zeng Lingcheng, Wang Yan, Wang Yu, Han Lin, Niu Hongquan, Zhang Mengxian, Ke Changshu, Chen Jian, Lei Ting
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Neurosurgery, Guanggu Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
J Neurooncol. 2017 Jan;131(1):153-161. doi: 10.1007/s11060-016-2282-y. Epub 2016 Sep 26.
Increasing evidence has suggested a close relationship between solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) in the central nervous system (CNS). However, CNS SFTs differentiate from HPCs in their clinical behavior and patient prognoses. Analyses of prognosis-related factors can help clarify the relationship between SFT and HPC. The intracranial SFT and HPC cases treated in our departments from January 2002 to December 2012 were retrospectively reviewed. The SFT and HPC cases were also combined into an SFT/HPC group. The factors associated with patient progression-free survival (PFS) and overall survival (OS) were statistically analyzed using uni- and multivariate analyses. Fifty-eight intracranial SFT/HPC patients including 38 SFT patients and 20 HPC patients were treated during this period. The "Marseille grading" evaluated upon the histological aggressive phenotypes was applied in this study. The grading reflected a malignant progression ranging from "conventional" SFTs (grade I) to WHO III HPCs (grade III), and grade was negatively correlated with the PFS and OS of the SFT, HPC and SFT/HPC patients (P < 0.05).The multivariate analyses revealed that gross total resection (GTR) was significantly positively correlated with PFS and OS in the SFT, HPC and SFT/HPC patients and that radiotherapy was significantly positively correlated with PFS in the HPC and SFT/HPC patients (P < 0.05). In conclusion, the intracranial SFTs and HPCs share common prognostic factors including extent of surgery and pathology, moreover, the histological grading of the aggressive phenotypes supports the unifying of the CNS SFT and HPC into one tumor entity of SFT/HPC.
越来越多的证据表明，中枢神经系统（CNS）中的孤立性纤维瘤（SFT）与血管外皮细胞瘤（HPC）之间存在密切关系。然而，CNS SFT在临床行为和患者预后方面与HPC有所不同。对预后相关因素的分析有助于阐明SFT和HPC之间的关系。我们回顾性分析了2002年1月至2012年12月在我们科室接受治疗的颅内SFT和HPC病例。SFT和HPC病例也合并为一个SFT/HPC组。使用单因素和多因素分析对与患者无进展生存期（PFS）和总生存期（OS）相关的因素进行了统计学分析。在此期间共治疗了58例颅内SFT/HPC患者，其中包括38例SFT患者和20例HPC患者。本研究采用基于组织学侵袭性表型的“马赛分级”。该分级反映了从“传统”SFT（I级）到世界卫生组织III级HPC（III级）的恶性进展，分级与SFT、HPC和SFT/HPC患者的PFS和OS呈负相关（P<0.05）。多因素分析显示，在SFT、HPC和SFT/HPC患者中，全切除（GTR）与PFS和OS显著正相关，放疗在HPC和SFT/HPC患者中与PFS显著正相关（P<0.05）。总之，颅内SFT和HPC具有共同的预后因素，包括手术范围和病理，此外，侵袭性表型的组织学分级支持将CNS SFT和HPC统一为一个SFT/HPC肿瘤实体。
