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提高脂肪肉瘤预后——一种整合组织病理学见解的新预测评分系统

"Enhancing Liposarcoma Prognosis - A New Predictive Scoring System Integrating Histopathological Insights".

作者信息

Ciongariu Ana-Maria, Țăpoi Dana Antonia, Dumitru Adrian-Vasile, Enache Valentin, Marin Andrei, Creangă Cosmin A, Costache Mariana

机构信息

Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, 020021, Romania.

Department of Pathology, University Emergency Hospital Bucharest, Bucharest, 050098, Romania.

出版信息

Cancer Manag Res. 2025 Feb 17;17:331-348. doi: 10.2147/CMAR.S504889. eCollection 2025.

DOI:10.2147/CMAR.S504889
PMID:39990278
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11844267/
Abstract

INTRODUCTION

Liposarcomas are malignant soft tissue tumours with heterogeneous features and variable prognosis. Each entity comprised in this group displays distinct morphology and harbours specific genetic alterations, which correlate with clinical behaviour and therapy response. The aim of this study is to analyse the clinical and histopathological features that can influence the prognosis of liposarcoma. We also present a newly designed scoring system that could be useful for predicting the risk of disease progression and death in patients with different liposarcoma subtypes.

MATERIALS AND METHODS

We carried out a retrospective multicentric study on 77 liposarcomas diagnosed between 2009 and 2023 that were followed up to assess the presence of metastases and survival of the patients. We evaluated the age, gender, tumour location and dimensions, histological subtype, mitotic index, presence and percentage of necrosis, and their association with disease progression and survival.

RESULTS

In this respect, progression-free survival was positively associated with lower mitotic index, somatic soft-tissue localization, well-differentiated and myxoid subtypes and absence of necrosis. Overall survival was negatively influenced by older age, higher mitotic index, dedifferentiated and pleomorphic subtypes and the presence of necrosis. Therefore, several clinical and histopathological features of liposarcomas, such as tumour location, mitotic index, and tumour necrosis can strongly predict the disease evolution.

DISCUSSION

This study focuses on developing a new scoring system that considers histologic subtype, mitotic index, and tumour necrosis as indicators that could predict the risk of disease progression and overall survival in patients with liposarcoma. The system classifies liposarcomas of any histological subtype into low-risk and high-risk tumours. Diagnosing liposarcomas using this two-tiered system could be useful for providing personalized therapy, in order to avoid relapses, metastases and improve the disease's prognosis.

摘要

引言

脂肪肉瘤是具有异质性特征和不同预后的恶性软组织肿瘤。该组中的每个实体都表现出独特的形态，并具有特定的基因改变，这些改变与临床行为和治疗反应相关。本研究的目的是分析可能影响脂肪肉瘤预后的临床和组织病理学特征。我们还提出了一种新设计的评分系统，该系统可能有助于预测不同脂肪肉瘤亚型患者疾病进展和死亡的风险。

材料与方法

我们对2009年至2023年间诊断的77例脂肪肉瘤进行了一项回顾性多中心研究，对患者进行随访以评估转移情况和生存情况。我们评估了年龄、性别、肿瘤位置和大小、组织学亚型、有丝分裂指数、坏死的存在及百分比，以及它们与疾病进展和生存的关联。

结果

在这方面，无进展生存期与较低的有丝分裂指数、躯体软组织定位、高分化和黏液样亚型以及无坏死呈正相关。总生存期受到年龄较大、有丝分裂指数较高、去分化和多形性亚型以及坏死存在的负面影响。因此，脂肪肉瘤的一些临床和组织病理学特征，如肿瘤位置、有丝分裂指数和肿瘤坏死，可以强烈预测疾病的演变。

讨论

本研究着重于开发一种新的评分系统，该系统将组织学亚型、有丝分裂指数和肿瘤坏死视为可预测脂肪肉瘤患者疾病进展风险和总生存期的指标。该系统将任何组织学亚型的脂肪肉瘤分为低风险和高风险肿瘤。使用这种两级系统诊断脂肪肉瘤可能有助于提供个性化治疗，以避免复发、转移并改善疾病预后。

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