30例隆突性纤维肉瘤的临床病理分析

Clinicopathological Analysis of 30 Cases of Fibrosarcoma Protuberans

目的分析隆突性纤维肉瘤的疾病特点,研究临床病理结果在30例隆突性纤维肉瘤患者中的具体表现。方法随机选取我院2010年7月至2014年8月收治的隆突性纤维肉瘤患者30例,回顾分析其临床资料。总结患者临床病理特征,包括基础资料(患病年龄、患病位置、随访情况)、病理特征(分析巨检数据、镜下特点、免疫组化染色)。结果患病位置:17例位于躯干,8例位于四肢,4例位于头颈部,1例位于手部。随访情况:手术患者28例、手术后实施放疗的患者2例,随访6个月~5年,平均(3.10±0.80)年,3例患者复发,术后2、3、4年各1例,复发率为10.00%。病理特征:巨检数据方面,结节/斑块为单发性的患者20例、融合多结节患者10例。肿瘤长径1.02~9.10 cm,分叶状/结节为主要形态。镜下特点,有席纹状或车辐状梭形肿瘤细胞出现于皮下脂肪或真皮中下层,对皮下脂肪产生深入分割情况,且有蜂窝状结构表现。对患者组织实施免疫生化染色检查,可发现存在100%阳性率的项目为Vimentin以及CD_(34),S-100及CD_(68)阳性率则分别为13.33%及16.67%。结论在临床中为了准确鉴别诊断隆突性纤维肉瘤,需对其病理典型特征及免疫组化特点进行综合分析,以提高诊断准确性。

Objective To analyze the characteristics of fibrosarcoma protuberans disease and study the specific manifestations of clinicopathological results in 30 patients with fibrosarcoma protuberans.Methods Thirty patients with fibrosarcoma protuberans who were admitted to our hospital from July 2010 to August 2014 were randomly selected,their clinical data were retrospectively analyzed.Summarize the clinical and pathological characteristics of patients,including analysis of basic data(age of disease,disease location,follow-up status),analysis of medical record characteristics(analysis of macroscopic examination data,microscopic characteristics,immunohistochemical staining).Results Sick location:17 cases were located on the trunk,8 cases were on the limbs,4 cases were on the head and neck,and 1 case was on the hands.Follow-up:28 patients undergoing surgery and 2 patients undergoing radiotherapy after surgery.The follow-up was 6 months to 5 years,with an average of(3.10±0.80)years,3 patients had recurrence,1 patient in each of 2,3,and 4 years after operation,and the recurrence rate was 10.00%.Analyzing the characteristics of the medical records,and the data of the macro examination,there were 20 patients with single nodules/plaques and 10 patients with fusion multiple nodules.The long diameter of the tumor is 1.02-9.10 cm,and the main shape is lobulated/nodular.Microscopic features,matstripe or car-spoke-shaped spindle-shaped tumor cells appear in subcutaneous fat or the middle and lower layers of the dermis,which produce deep segmentation of subcutaneous fat,and have a honeycomb structure.The immuno-biochemical staining of the patient's tissues revealed that the 100% positive rates were vimentin and CD_(34).The positive rates of S-100 and CD_(68) were 13.33%and 16.67%,respectively.Conclusion In order to accurately differentiate and diagnose fibrosarcoma protuberans in the clinic,a comprehensive analysis of its typical pathological characteristics and immunohistochemical characteristics is necessary to improve the accuracy of diagnosis.