实用肿瘤学杂志 ›› 2016, Vol. 30 ›› Issue (6): 511-515.doi: 10.11904/j.issn.1002-3070.2016.06.007

• 论著 • 上一篇    下一篇

上皮样肉瘤的临床诊疗及预后因素分析

董磊,刘清,江仁兵   

  1. 新疆医科大学附属肿瘤医院(乌鲁木齐 830000)
  • 收稿日期:2016-06-20 出版日期:2016-12-31 发布日期:2016-12-27
  • 通讯作者: 江仁兵,E-mail:392472317@qq.com
  • 作者简介:董磊,男,(1991-),硕士研究生,从事骨肿瘤及四肢软组织肿瘤的研究
  • 基金资助:
    自治区成果转化项目(201454136)

Analysis of clinical diagnosis,treatment and prognosis of epithelioid sarcoma

DONG Lei,LIU Qing,JIANG Renbing   

  1. Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830000,China
  • Received:2016-06-20 Online:2016-12-31 Published:2016-12-27

摘要: 目的 分析上皮样肉瘤(Epithelioid sarcoma,ES)的临床特点、诊疗与预后的影响因素,为临床的诊疗提供依据。方法 对我院2010年1月—2015年12月间收治并获得随访31例上皮样肉瘤临床资料进行回顾性分析和生存分析,总结其临床特点,术前诊断及术后复发的相关数据,以性别、年龄、肿瘤类型、肿瘤大小、有无放化疗为因素,进行复发因素的相关性分析。结果 本组6例患者死亡,5年总生存率78.8%。31例均获随访,随访时间为3~56个月,中位时间为27个月。5年复发率为70.9%,在单因素分析中,影响5年复发率的因素为肿瘤的类型及肿瘤大小,其中肿瘤>5 cm与≤5 cm相比,肿瘤近端型与远端型相比,前者的5年复发率均高于后者(P<0.05)。全组中CD34阳性表达占90.3%,INI1表达缺失占83.9%。对于肿瘤与周围血管神经界限不清的患者,给予术前放疗后可手术治疗,避免截肢。结论 ES的复发与肿瘤大小、肿瘤分型具有相关性,CD34、INI1等免疫组化检测以帮助鉴别诊断,术前放疗在一定情况下可避免截肢,提高患者生活质量。

关键词: 上皮样肉瘤, 诊断, 治疗, 预后, INI1

Abstract: Objective To analyze the influence factors of epitheliod sarcoma(ES)diagnosis and prognosis of clinical characteristics,and to invoke as a basis for clinical diagnosis and treatment.Methods The patients admitted in our hospital from January 2010 to December 2015 and follow-up of 31 cases of epitheliod sarcoma clinical data were retrospectively analyzed and survival analysis and summarized the clinical features.Preoperative diagnosis,and postoperative recurrence of relevant data,with gender,age,tumor type,tumor size,chemoradiotherapy factors and recurrence factors were correlatively analyzed.Results In this group,6 patients died,the 5 year overall survival rate was 78.8%.All 31 cases were followed between 3 to 56 months.The median time was 27months.Five year recurrence rate was 70.9%.In the single factor analysis,the impact of 5 year recurrence rates of factors for tumor type and tumor size.The tumors were more than 5cm and less than or equal to 5cm compared,tumor of the proximal and distal compared,the preceding 5 year recurrence rate was greater than in the latter(P<0.05).In the control group,the explicit expression of CD34 was 90.3%,and the expression of INI1 was 83.9%.For the patients with tumor and peripheral vascular nerve boundary were not sharp,we provided preoperative radiotherapy after surgical treatment to avoid amputation.Conclusion Epithelioid sarcoma recurrence is associated with tumor size and tumor type.CD34,INI1 immune group treatment can be helpful in the differential diagnosis.Preoperative radiotherapy can avoid amputation so as to improve the quality of the patients′ life.

Key words: Epithelioid sarcoma, Diagnosis, Treatment, Prognosis, INI1

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