50例四肢脂肪肉瘤的临床特点及预后分析

Clinical characteristics and prognosis analysis of 50 cases of extremity liposarcoma

目的探讨四肢脂肪肉瘤患者的病理、影像学特征,分析影响患者无进展生存的独立危险因素。方法收集50例四肢脂肪肉瘤患者资料,分析治疗前核磁共振影像特点,观察手术切除标本的组织病理类型、分级及Ki-67表达;采用单因素方差分析患者性别、年龄、脂肪肉瘤的病理类型、肿瘤大小、侵及深度、疾病分期、治疗方式、Ki-67表达水平及进展生存时间的差异,并对有差异的指标采用Cox回归分析,评估患者预后独立影响因素。结果患者平均年龄(49.24±11.01)岁,肿瘤大小0.5~22 cm,发病部位下肢44例、上肢6例;病理类型包括黏液性、多形性、高分化和去分化,去分化和多形性患者增殖细胞抗原Ki-67阳性表达率高于黏液性和高分化患者(P<0.05);单因素分析显示,四肢脂肪肉瘤患者3年无进展生存与肿瘤大小和年龄相关(P<0.05),5年无进展生存与治疗方式相关(P<0.05);多因素分析结果显示,肿瘤大小是四肢脂肪肉瘤患者3年无进展生存的独立影响因素,疾病分期是四肢脂肪肉瘤患者5年无进展生存的独立影响因素。结论四肢脂肪肉瘤的大小是肿瘤患者3年无进展生存率的相关因素,肿瘤的病理分级是患者术后5年无进展生存率的相关因素。

Objective To investigate the pathological and radiological characteristics of patients with extremity liposarcoma,and to analyze the independent risk factors affecting the patients'progression-free survival.Methods Data from 50 patients with extremity liposarcoma were collected,and the characteristics of pre-treatment magnetic resonance imaging,the histopathological types and grading of surgical resection specimens,and proliferating cell antigen Ki-67 expression were analyzed.Univariate analysis of variance was used to analyze the differences in patient gender,age,pathological type of liposarcoma,tumor size,invasion depth,disease stage,treatment method,Ki-67 expression level,and progression-free survival time.Cox regression analysis was used to evaluate the independent prognostic factors for patients with significant differences.Results The average age of the patients was(49.24±11.01)years,and the tumor size ranged from 0.5 to 22 cm.The disease occurred in the lower limbs in 44 cases and in the upper limbs in 6 cases.The pathological types included mucinous,pleomorphic,well-differentiated,and dedifferentiated.The positive expression rate of Ki-67 in patients with dedifferentiated and pleomorphic was higher than that in patients with mucinous and well-differentiated(P<0.05).Univariate analysis showed that the 3-year progression-free survival of patients with extremity liposarcoma was related to tumor size and age(P<0.05),and the 5-year progression-free survival was related to the treatment method(P<0.05).Multivariate analysis results showed that tumor size was an independent influencing factor for the 3-year progression-free survival of patients with extremity liposarcoma,and disease stage was an independent influencing factor for the 5-year progression-free survival of patients with extremity liposarcoma.Conclusion The size of extremity liposarcoma is a related factor for the 3-year progression-free survival rate of tumor patients,and the pathological grading of the tumor is a related factor for the 5-year progression-free survival rate of patients after surgery.