BACKGROUND Malignant peripheral nerve sheath tumor(MPNST)is a rare and aggressive soft tissue sarcoma that poses a major diagnostic and therapeutic challenge.CASE SUMMARY We retrospectively reviewed patients with head...BACKGROUND Malignant peripheral nerve sheath tumor(MPNST)is a rare and aggressive soft tissue sarcoma that poses a major diagnostic and therapeutic challenge.CASE SUMMARY We retrospectively reviewed patients with head and neck MPNSTs treated in our hospital from 2000 to 2021.The clinical features,pathological manifestations,treatments,and prognoses were summarized.We also reviewed the literature,focusing on MPNST in the mandible and maxilla.The study population consisted of five women and five men aged 22–75 years(mean age,49 years).Of the 10 patients,7 were initial cases and 3 were recurrent cases.All lesions were sporadic.The most common site was the mandible.The most frequently encountered symptoms were a progressive mass and local swelling.Complete or partial loss of trimethylation at lysine 27 of histone H3(H3K27me3)was evident on staining in four of nine cases(one case was excluded due to lack of tissue for evaluation of loss of H3K27me3).The 2-and 5-year disease-specific survival rates were 86%a nd 43%,respectively.The average survival time was 64 mo.CONCLUSION MPNST is a highly malignant tumor with a poor prognosis,prone to a high risk of recurrence and distant metastasis.Complete surgical resection is the main treatment.展开更多
目的:本研究目的为比较改良胸大肌肌皮瓣(modified pectoralis major myocutaneous flap,mPMMF与传统胸大肌肌皮瓣pectoralis major myocutaneous flap,PMMF)在修复颌面部及口咽部恶性肿瘤术后大型缺损的效果。方法:本研究纳入28例原发...目的:本研究目的为比较改良胸大肌肌皮瓣(modified pectoralis major myocutaneous flap,mPMMF与传统胸大肌肌皮瓣pectoralis major myocutaneous flap,PMMF)在修复颌面部及口咽部恶性肿瘤术后大型缺损的效果。方法:本研究纳入28例原发口腔颌面部及口咽部恶性肿瘤患者,行病灶扩大切除术后遗留口腔-咽部大型缺损,分别使用常规胸大肌皮瓣和改良胸大肌皮瓣进行术区组织缺损修复,比较两组患者术中及术后各项指标。结果:改良胸大肌皮瓣及传统胸大肌皮瓣血管蒂的长度分别为18cm^(2)6cm(平均21.6cm)以及17cm^(2)3cm(平均19.3cm)。皮岛的面积分别为5×15到6×28cm^(2)(平均5.3×19.5cm^(2))以及5×7cm^(2)到5×12cm^(2)(平均5.0×8.7cm^(2))。术后随访6个月以上,改良胸大肌皮瓣组患者肩关节活动评分及术后生存质量量表得分均显著高于传统胸大肌皮瓣组,并且颈部外观及功能明显改善。结论:相比传统胸大肌肌皮瓣,改良胸大肌皮瓣的血管蒂更长,面积更大,外形更灵活可以修复多种形状的缺损,副损伤小,颈部外形及功能恢复更好,且术后肩关节活动范围更大,术后功能及生存质量更好,在修复颌面部及口咽部恶性肿瘤术后缺损方面值得进一步推广及应用。展开更多
目的探讨决策冲突在头颈部恶性肿瘤放化疗患者癌症信息超载(Cancer information overload,CIO)与恐惧疾病进展间的中介作用。方法2022年8月至2023年1月,采用便利抽样法选取承德医学院附属医院肿瘤科收治的241例头颈部恶性肿瘤行放化疗...目的探讨决策冲突在头颈部恶性肿瘤放化疗患者癌症信息超载(Cancer information overload,CIO)与恐惧疾病进展间的中介作用。方法2022年8月至2023年1月,采用便利抽样法选取承德医学院附属医院肿瘤科收治的241例头颈部恶性肿瘤行放化疗患者作为研究对象,采用一般资料调查表、癌症信息超载量表(cancer information overload scale,CIOS)、决策冲突量表(decisional conflict scale,DCS)、恐惧疾病进展量表(fear of progression questionnaire-short form,FoP-Q-SF)进行调查。结果头颈部恶性肿瘤放化疗患者的CIOS、DCS及FoP-Q-SF的总得分分别为(19.48±8.43)、(30.82±7.66)、(34.92±13.73)分;Pearson相关性分析结果显示,头颈部恶性肿瘤放化疗患者的CIOS与DCS、FoP-Q-SF呈两两正相关(均P<0.01);Bootstrap分析显示,DCS占头颈部恶性肿瘤放化疗患者CIOS和FoP-Q-SF中介效应值的32.19%。结论DCS在头颈部恶性肿瘤放化疗患者CIOS与FoP-Q-SF间起到部分中介作用,提示医务人员可以通过制定系统完善的健康宣教策略提高患者癌症信息素养,以缓解患者CIOS和DCS,从而改善患者FoP-Q-SF心境状态。展开更多
文摘BACKGROUND Malignant peripheral nerve sheath tumor(MPNST)is a rare and aggressive soft tissue sarcoma that poses a major diagnostic and therapeutic challenge.CASE SUMMARY We retrospectively reviewed patients with head and neck MPNSTs treated in our hospital from 2000 to 2021.The clinical features,pathological manifestations,treatments,and prognoses were summarized.We also reviewed the literature,focusing on MPNST in the mandible and maxilla.The study population consisted of five women and five men aged 22–75 years(mean age,49 years).Of the 10 patients,7 were initial cases and 3 were recurrent cases.All lesions were sporadic.The most common site was the mandible.The most frequently encountered symptoms were a progressive mass and local swelling.Complete or partial loss of trimethylation at lysine 27 of histone H3(H3K27me3)was evident on staining in four of nine cases(one case was excluded due to lack of tissue for evaluation of loss of H3K27me3).The 2-and 5-year disease-specific survival rates were 86%a nd 43%,respectively.The average survival time was 64 mo.CONCLUSION MPNST is a highly malignant tumor with a poor prognosis,prone to a high risk of recurrence and distant metastasis.Complete surgical resection is the main treatment.
文摘目的:本研究目的为比较改良胸大肌肌皮瓣(modified pectoralis major myocutaneous flap,mPMMF与传统胸大肌肌皮瓣pectoralis major myocutaneous flap,PMMF)在修复颌面部及口咽部恶性肿瘤术后大型缺损的效果。方法:本研究纳入28例原发口腔颌面部及口咽部恶性肿瘤患者,行病灶扩大切除术后遗留口腔-咽部大型缺损,分别使用常规胸大肌皮瓣和改良胸大肌皮瓣进行术区组织缺损修复,比较两组患者术中及术后各项指标。结果:改良胸大肌皮瓣及传统胸大肌皮瓣血管蒂的长度分别为18cm^(2)6cm(平均21.6cm)以及17cm^(2)3cm(平均19.3cm)。皮岛的面积分别为5×15到6×28cm^(2)(平均5.3×19.5cm^(2))以及5×7cm^(2)到5×12cm^(2)(平均5.0×8.7cm^(2))。术后随访6个月以上,改良胸大肌皮瓣组患者肩关节活动评分及术后生存质量量表得分均显著高于传统胸大肌皮瓣组,并且颈部外观及功能明显改善。结论:相比传统胸大肌肌皮瓣,改良胸大肌皮瓣的血管蒂更长,面积更大,外形更灵活可以修复多种形状的缺损,副损伤小,颈部外形及功能恢复更好,且术后肩关节活动范围更大,术后功能及生存质量更好,在修复颌面部及口咽部恶性肿瘤术后缺损方面值得进一步推广及应用。
文摘目的探讨决策冲突在头颈部恶性肿瘤放化疗患者癌症信息超载(Cancer information overload,CIO)与恐惧疾病进展间的中介作用。方法2022年8月至2023年1月,采用便利抽样法选取承德医学院附属医院肿瘤科收治的241例头颈部恶性肿瘤行放化疗患者作为研究对象,采用一般资料调查表、癌症信息超载量表(cancer information overload scale,CIOS)、决策冲突量表(decisional conflict scale,DCS)、恐惧疾病进展量表(fear of progression questionnaire-short form,FoP-Q-SF)进行调查。结果头颈部恶性肿瘤放化疗患者的CIOS、DCS及FoP-Q-SF的总得分分别为(19.48±8.43)、(30.82±7.66)、(34.92±13.73)分;Pearson相关性分析结果显示,头颈部恶性肿瘤放化疗患者的CIOS与DCS、FoP-Q-SF呈两两正相关(均P<0.01);Bootstrap分析显示,DCS占头颈部恶性肿瘤放化疗患者CIOS和FoP-Q-SF中介效应值的32.19%。结论DCS在头颈部恶性肿瘤放化疗患者CIOS与FoP-Q-SF间起到部分中介作用,提示医务人员可以通过制定系统完善的健康宣教策略提高患者癌症信息素养,以缓解患者CIOS和DCS,从而改善患者FoP-Q-SF心境状态。
