Fujibuchi Taketsugu, Miyawaki Joji, Kidani Teruki, Imai Hiroshi, Miura Hiromasa
Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
Cancers (Basel). 2020 Mar 13;12(3):679. doi: 10.3390/cancers12030679.
The accurate diagnosis of soft tissue tumors may be difficult. Simple clinical characteristics or laboratory data that can predict tumor malignancy can be useful tools for diagnosing soft tissue tumors. Between 2003 and 2018, 588 patients with primary soft tissue tumors were retrospectively reviewed. Their clinical characteristics and laboratory data were evaluated to determine their association with the diagnosis of benign, intermediate, or malignant tumor. Multivariable analysis revealed that tumor size ≥ 5.6 cm (odds ratio (OR), 6.15; < 0.001), white blood cell (WBC) count ≥ 5700/µL (OR, 2.49; = 0.002), hemoglobin (Hb) count ≤ 12.4 g/dL (OR, 2.56; = 0.004), C-reactive protein (CRP) level ≥ 0.17 mg/dL (OR, 2.64; < 0.001), and lactate dehydrogenase (LDH) level ≥ 240 IU/L (OR, 4.94; < 0.001) were significant predictive factors for sarcoma. The sensitivity and specificity in the presence of three or more predictive factors for detecting malignant tumors were 0.58 and 0.90 respectively, and it was an appropriate threshold with the maximum Youden's index of 0.49. Simple clinical and laboratory data were useful tools for predicting whether the tumor is malignant. Patients with soft tissue tumors that meet any three or more predictive factors should be referred to a specialist.
软组织肿瘤的准确诊断可能具有挑战性。能够预测肿瘤恶性程度的简单临床特征或实验室数据可成为诊断软组织肿瘤的有用工具。对2003年至2018年间588例原发性软组织肿瘤患者进行了回顾性分析。评估他们的临床特征和实验室数据,以确定其与良性、中间性或恶性肿瘤诊断的相关性。多变量分析显示,肿瘤大小≥5.6 cm(比值比(OR),6.15;P<0.001)、白细胞(WBC)计数≥5700/µL(OR,2.49;P = 0.002)、血红蛋白(Hb)计数≤12.4 g/dL(OR,2.56;P = 0.004)、C反应蛋白(CRP)水平≥0.17 mg/dL(OR,2.64;P<0.001)以及乳酸脱氢酶(LDH)水平≥240 IU/L(OR,4.94;P<0.001)是肉瘤的显著预测因素。存在三个或更多预测因素时检测恶性肿瘤的敏感性和特异性分别为0.58和0.90,这是具有最大约登指数0.49的合适阈值。简单的临床和实验室数据是预测肿瘤是否为恶性的有用工具。符合任何三个或更多预测因素的软组织肿瘤患者应转诊至专科医生处。