de la Monte S M, Hutchins G M, Moore G W
Pathol Res Pract. 1986 May;181(2):148-52. doi: 10.1016/s0344-0338(86)80003-6.
Embryonal and alveolar rhabdomyosarcoma probably have the same histogenesis, yet alveolar rhabdomyosarcoma has a considerably worse prognosis and is generally less responsive to treatment. The metastatic behavior of rhabdomyosarcoma in 22 autopsied subjects was analyzed with respect to the histologic subtypes of the tumors to determine whether the more aggressive behavior of alveolar rhabdomyosarcoma was related to greater tumor burden and/or more widely disseminated metastases. Subjects with embryonal rhabdomyosarcoma tended to survive longer and had greater numbers of metastatic sites at autopsy compared to subjects with alveolar rhabdomyosarcoma, but these differences were not statistically significant. In addition, there were no significant differences in the overall distribution of metastases between embryonal and alveolar rhabdomyosarcoma. The most frequent sites of metastases from both types of tumor were soft tissues (73%), serosal surfaces (64%), lymph nodes (64%), lungs (55%), and bone marrow (50%). The findings suggest that the metastatic behavior of rhabdomyosarcoma does not vary as a function of length of survival, mode of therapy, or histologic subtype. We propose that factors such as stage of disease at presentation and location of the primary tumor, rather than histologic subtype, are probably the most important variables governing the therapeutic responsiveness of rhabdomyosarcoma.
胚胎型和腺泡型横纹肌肉瘤可能具有相同的组织发生学，但腺泡型横纹肌肉瘤的预后要差得多，并且通常对治疗的反应性较低。分析了22例尸检对象中横纹肌肉瘤的转移行为，以了解肿瘤的组织学亚型，从而确定腺泡型横纹肌肉瘤更具侵袭性的行为是否与更大的肿瘤负荷和/或更广泛扩散的转移有关。与腺泡型横纹肌肉瘤患者相比，胚胎型横纹肌肉瘤患者往往存活时间更长，尸检时转移部位更多，但这些差异无统计学意义。此外，胚胎型和腺泡型横纹肌肉瘤之间转移的总体分布也没有显著差异。两种类型肿瘤最常见的转移部位是软组织（73%）、浆膜表面（64%）、淋巴结（64%）、肺（55%）和骨髓（50%）。这些发现表明，横纹肌肉瘤的转移行为不会因生存时间、治疗方式或组织学亚型而有所不同。我们认为，就诊时的疾病分期和原发肿瘤的位置等因素，而非组织学亚型，可能是决定横纹肌肉瘤治疗反应性的最重要变量。
