Wang Wei, Long Man-Mei, Wei Cheng-Jiang, Cui Xi-Wei, Ren Jie-Yi, Gu Yi-Hui, Li Qing-Feng, Dai Shun-Dong, Gu Bin, Wang Zhi-Chao
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Pathology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Ann Transl Med. 2021 Jul;9(13):1059. doi: 10.21037/atm-21-542.
Tenosynovial giant cell tumors (TGCTs), synovial chondromatosis (SC), and synovial sarcoma (SS) exhibit similarities in clinical features and histochemical characteristics, and differential diagnosis remains challenging in clinical practice.
Data were collected from the pathology database of Shanghai Ninth People's Hospital regarding patients who underwent surgery from 2010 to 2019 with histologically confirmed TGCTs, SC, and SS. Demographic and clinicopathological data of these patients were reviewed. Immunohistochemistry staining of 14 different markers was performed. Correlation analyses of the prognoses were evaluated.
A total of 26 patients with TGCTs (8 diffuse TGCTs and 18 localized TGCTs), 16 with SC, and 11 with SS were identified. Pain was the main symptom of patients with both TGCTs and SC, while a palpable mass was the most common symptom for patients with SS. In addition to clinical features, we identified vital risk factors for disease recurrence. The mean follow-up periods were 51, 39, and 14 months for TGCTs, SC, and SS, respectively. Younger patients with diffuse TGCTs or patients with a higher neutrophil/lymphocyte ratio (NLR) displayed a significantly higher frequency of recurrence. We also plotted receiver operating characteristic (ROC) curve analysis for age and NLR. The area under the ROC curve (AUC) was calculated and demonstrated the ability to distinguish recurrent from nonrecurrent cases. In addition, higher CD163 expression was linked to recurrent diffuse TGCT cases.
These data indicated possible characteristics of different aspects of TGCTs, SC, and SS. Further clarification and understanding of these factors will help with differential clinical diagnosis and recurrent risk assessment.
腱鞘巨细胞瘤（TGCTs）、滑膜软骨瘤病（SC）和滑膜肉瘤（SS）在临床特征和组织化学特征上存在相似之处，在临床实践中鉴别诊断仍然具有挑战性。
收集上海第九人民医院病理数据库中2010年至2019年接受手术且组织学确诊为TGCTs、SC和SS的患者数据。回顾这些患者的人口统计学和临床病理数据。进行14种不同标志物的免疫组织化学染色。评估预后的相关性分析。
共鉴定出26例TGCTs患者（8例弥漫性TGCTs和18例局限性TGCTs）、16例SC患者和11例SS患者。疼痛是TGCTs和SC患者的主要症状，而可触及肿块是SS患者最常见的症状。除临床特征外，我们还确定了疾病复发的重要危险因素。TGCTs、SC和SS的平均随访时间分别为51个月、39个月和14个月。弥漫性TGCTs的年轻患者或中性粒细胞/淋巴细胞比值（NLR）较高的患者复发频率显著更高。我们还绘制了年龄和NLR的受试者工作特征（ROC）曲线分析。计算ROC曲线下面积（AUC），并证明其区分复发与非复发病例的能力。此外，较高的CD163表达与弥漫性TGCT复发病例相关。
这些数据表明了TGCTs、SC和SS不同方面的可能特征。进一步阐明和理解这些因素将有助于临床鉴别诊断和复发风险评估。
