85例软组织肉瘤回顾分析及软组织肉瘤诊治进展

Diagnosis and treatment of soft tissue sarcoma --- 85 cases report

目的通过近5年85例软组织肉瘤回顾分析以探索本地区软组织肉瘤的临床特点及诊治进展。方法采用经病理证实的软组织肉瘤的调查统计,对此临床资料进行回顾性发析。结果好发年龄段为30～70岁,占78.8%(67/85);发病部位依次为下肢、躯干、腹腔、后腹膜、上肢及头颈,前3位占65.8%(56/85);前6位病理类型为纤维肉瘤、平滑肌肉瘤、恶性纤维组织细胞瘤、皮肤隆突性纤维肉瘤、横纹肌及滑膜肉瘤,占69.4%(59/85)。常见转移部位为肺、肝、淋巴结和多发转移,远处转移占58.8%,大多属III及IV期期局部复发近30%;预后与肿瘤大小、部位、深度、分期、分级、复发几率及转移灶数目有关。结论本组软组织肉瘤病种复杂,分布广泛,异质性明显;病期晚,肿块大且转移多见。诊断采用CT、MRI为主的影像学、病理形态学及免疫组织化学(IHC),必要时加电镜检查;治疗以手术为主,手术加放疗为基础模式,据分期、分级和生物学特性加高活性联合方案等综合治疗,软组织肉瘤靶向治疗为目前研究热点。

Objective To evaluate the treatment effect and advance in soft tissue sarcoma treatment by retrospectively 85 cases of soft tissue sarcoma study. Methods All the 85 cases were proved histologically and their clinical characteristics and pathologic results were analyzed. Results Soft tissue sarcoma often appears at the age of 30 to 70 year old （78.8%）. The common sites are lower limbs, trunk, abdomen, retroperitonea, upper limbs ,head and neck. The common pathology types are fibrosarcoma, leiomyosarcoma and fibrous histiocytoma. The common metastatic sites are lung, liver and regional lymph nodes （58.5 percent）. Local recurrent rate after surgery was about 30 percent. The prognosis is related to the tumor size, site, clinic stage and pathology grade, recurrent rate and the number of metastasis. Conclusions Soft tissue sarcomas in our study group were very complicated and has obvious heterogenicity and could be in advanced clinic stage. The tumor size could be very large and easy to spread to other organs. The CT, MRI and pathology are main diagnosis methods. Operation is the main treatment. Combined with radiotherapy is the standard treatment.