胸膜孤立性纤维瘤的临床诊治

Diagnosis and treatment of the solitary fibrous tumor of the pleura

[目的]探讨胸膜孤立性纤维瘤（solitary fibrous tumor of the pleura,SFTP）的临床特点及治疗方法。[方法]回顾性分析大连医科大学附属第二医院胸外科2006年-2009年收治的10名胸膜孤立性纤维瘤患者的临床资料,10例患者均行手术切除肿瘤,其中2例术前行介入栓塞治疗,术后肿瘤组织行病理检查及免疫组化分析。[结果]病理检查提示肿瘤组织主要由梭形细胞和胶原纤维组成,免疫组化分析CD34、Vimentin、Bc1-2均为阳性表达,CD99部分阳性表达（2例）。10例患者中,术前行介入栓塞治疗的2名患者术中出血明显减少;术后病理诊断均为胸膜孤立性纤维瘤,术后随访8个月-2年,效果良好迄今为止,未发现肿瘤转移复发。[结论]手术是目前治疗SFTP的最佳方法,术前行介入治疗能够有效地减少术中出血。免疫组化对该病的诊断具有重要价值。

[Objective] To explore clinical characteristics and treatment of the solitary fibrous tumor of the pleura（SFTP）.[Methods] Clinical records of 10 SFTP patients were retrospectively analyzed.All the patients received surgical operation during the period of 2006 to 2009,and two of them were treated with intervention and embolization before the operation.All the cases were investigated by pathological and immunohistochemical analysis.[Results] The main pathologic appearance was that tumor tissue composed of spindle cells and collagen fibers.Immunohistochemistry results showed that the CD34,Vimentin and Bc1-2 were positive expression in 10 cases,and CD99 was positive expression in 2 cases.All the patients had undergone surgical operation and the 2 patients who did the interventional treatment were less bleeding in the operation.Pathological diagnoses showed SFTP in all of the patients.The surgical treatment was effective in all the patients.All the patients have been found well with no metastasis and recurrence from following-up for 8 to 24 months so far.[Conclusion] The surgical operation is the best method for SFTP currently.Pre-interventional treatment can reduce bleeding in the operation.The immunohistochemical exam plays an important role in the diagnosis of SFTP.