腹部恶性纤维组织细胞瘤28例临床分析

An analysis of intraabdominal malignant fibrous histocytoma in 28 cases

目的探讨腹部恶性纤维组织细胞瘤的诊治方法。方法回顾性分析28例腹部恶性纤维组织细胞瘤的临床表现、影像学特征、病理学特点、治疗方法、疗效和预后。结果 28例中 17例来源于腹膜后,6例来源于腹腔脏器,3例来源于肠系膜,2例来源于腹壁,主要临床表现为明显消瘦,体重减轻、腹痛和腹部肿块。B超和CT扫描提示腹部占位性病变。肿瘤≥2个24例,单发 4例。根治性切除17例,部分切除11例,术后联合化疗16例,联合放疗14例。术后1、3、5年生存率分别为76．9％,26．9％和3．9％。结论腹部恶性纤维组织细胞瘤主要来源于腹膜后,常多发,手术切除是首选的治疗方法,术后联合放化疗,可能改善患者预后。

Objective To investigate the diagnosis and treatment of malignant fibrous histiocytoma （MFH） in abdominal cavity. Methods The clinical manifestations, imaging examination, pathology, methodology, effect of treatment and prognosis of 28 MFH patients were retrospectively analyzed. Results Tumors were in the retroperitoneal space in 17 cases, within abdominal cavity in 6, in mesentery in 3 cases, and in the abdominal wall in 2 cases. The clinical symptoms were body weight loss, abdominal pain and mass. B ultrasonography and CT scanning showed mass in the abdomen. 24 cases were with multiplefoci,4 cases were with a single mass. Seventeen cases underwent complete tumor resection, 11 cases with partial resection, 16 cases received postoperative chemotherapy and 14 cases with postoperative radiotherapy. The overall survival rate of 1-, 3- and 5- year was 76. 9%, 26. 9% and 3.9%, respectively. Conclusion MFH is most often located in retroperitoneal space, surgical resection was the treatment of choice. The prognosis in patients with MFH might be improved by complete resection combined with chemotherapy or/ and radiotherapy.