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腹膜后孤立性纤维瘤的临床病理分析:31 例研究。

Clinicopathological analysis of retroperitoneal solitary fibrous tumours: a study of 31 cases.

机构信息

Department of Pathology, Maoming People's Hospital, Maoming, Guangdong, China.

Department of Pathology, The First People's Hospital of Yueyang, Yueyang, Hunan, China.

出版信息

Histol Histopathol. 2022 Jan;37(1):43-50. doi: 10.14670/HH-18-392. Epub 2021 Nov 8.

Abstract

A solitary fibrous tumour (SFT) is a mesenchymal tumour that exhibits fibroblast differentiation and rarely occurs in the retroperitoneum. The main purpose of this study was to explore the clinical manifestation, histopathological features and biological behaviour of retroperitoneal SFT. From 2011 to 2020, 31 patients were hospitalized and diagnosed with retroperitoneal SFTs. We summarized and analysed the morphological features, immunophenotype, treatment and prognosis. Patients (13 M; 18 F) ranged in age from 25 to 79 years with a mean age of 53.6 years. The main symptoms included an abdominal mass (48.4%) and abdominal discomfort (25.8%). The mean maximum diameter of the tumours was 12.9 cm (range, 4-40 cm). Histopathologically, there were 17 classic cases and 14 hemangiopericytoma-like cases. The tumour cells were positive for STAT6 (96.8%), CD34 (96.8%), CD99 (93.5%) and BCL-2 (90.3%). All patients were treated with complete surgical excision, and 3 of the patients also received chemotherapy. After a median follow up period of 44 months (range, 6 to 107 months), 2 patients died. Patients in the high- or intermediate-risk group were prone to metastasis and/or recurrence. The sites of metastases and/or recurrences involved the liver, bone and pelvis. The Ki-67 labelling index in the high-intermediate risk group (median, 10%) was significantly higher than that in the low-risk group (median, 3%). The retroperitoneal SFT demonstrates an indolent clinical course, and patients from the high- or intermediate-risk group require close follow-up. A Ki-67 labelling index ≥10% may be used as an important reference for prognosis.

摘要

孤立性纤维瘤(SFT)是一种具有成纤维细胞分化特征的间叶性肿瘤,很少发生在后腹膜。本研究旨在探讨后腹膜 SFT 的临床表现、组织病理学特征和生物学行为。2011 年至 2020 年,31 例患者因后腹膜 SFT 住院并接受诊断。我们对其形态学特征、免疫表型、治疗和预后进行了总结和分析。患者(男 13 例,女 18 例)年龄 25-79 岁,平均年龄 53.6 岁。主要症状包括腹部肿块(48.4%)和腹部不适(25.8%)。肿瘤最大直径为 12.9cm(4-40cm)。组织病理学上,经典型 17 例,血管外皮细胞瘤样型 14 例。肿瘤细胞 STAT6(96.8%)、CD34(96.8%)、CD99(93.5%)和 BCL-2(90.3%)阳性。所有患者均接受完全手术切除,3 例患者还接受了化疗。中位随访时间 44 个月(6-107 个月),2 例患者死亡。高/中危组患者易发生转移和/或复发。转移和/或复发部位包括肝、骨和骨盆。高-中危组的 Ki-67 标记指数(中位数 10%)明显高于低危组(中位数 3%)。后腹膜 SFT 具有惰性的临床过程,高/中危组患者需要密切随访。Ki-67 标记指数≥10%可能是预后的重要参考。

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