盆腔孤立性纤维瘤的临床诊治特点及预后分析

目的探讨盆腔孤立性纤维瘤( solitary fibrous tumor，SFT)临床病理特点、诊治现状及预后。方法复习国内外文献，回顾性分析 2010年 1月至 2019年 7月西安交通大学第一附属医院 5例经手术切除及病理确诊为盆腔 SFT的病人病例资料，采用 HE和免疫组织化学 SP法检测 Vim、CD34、CD99、Ki-67、bcl-2和 S-100的表达，分析其临床病理特点及预后。结果 5例 SFT病人平均年龄 54岁，分别发生于腹膜后、骶前、膀胱等盆腔位置。早期 SFT病人无任何典型临床表现，随着肿瘤体积增大，病灶局部逐渐出现肿块压迫症状。大体标本组织学示肿瘤内为伴血管外皮瘤样和黏液样变性的成束梭形细胞，其间隔不同范围的胶原纤维。免疫组化染色结果: Vim阳性率 100%(5/5)、 CD34 100%(5/5)、 CD99 80%(4/5)、 Ki-67 60%(3/5)、 bcl-2 60%(3/

Clinical characteristics and prognosis of pelvic solitary fibrous tumors

Objective Combined with clinical cases and literature reports, the clinicopathological features, diagnosis and treatmentstatus and prognosis of pelvic solitary fibrous tumors (SFTs) were discussed.Methods Reviewing domestic and foreign literature, weretrospectively analyzed the case data of 5 patients with pelvic SFT diagnosed by surgical resection and pathology from January 2010 toJuly 2019 in the First Affiliated Hospital of Xi''an Jiaotong University. HE and immunohistochemical SP methods were used to detectVim, CD34, CD99, Ki-67, bcl-2 and S-100 expression, and their clinicopathological characteristics and prognosis were analyzed.Re. sults The average age of the 5 SFT patients was 54 years, and they occurred in the retroperitoneum, presacral, bladder and other pel.vic locations. Early SFT patients do not have any typical clinical manifestations. With the increase in tumor volume, local tumor com.pression symptoms gradually appear. Gross specimen histology revealed bundles of spindle cells with hemangiopericytoma-like and myxoid degeneration within the tumor, separated by various ranges of collagen fibers. Immunohistochemical staining results: Vim posi.tive rate 100% (5/5), CD34 100% (5/5), CD99 80% (4/5), Ki-67 60% (3/5), bcl-2 60% (3/5), S-100, SMA, Des, and NSE were all 20% (1/5). All patients were effectively followed up, with an average follow-up of 37.4 months, and there was no recurrence or metastasis. Conclusion As a special and rare spindle cell tumor, the specificity of routine imaging and laboratory tests for SFT is low. The clini.cal diagnosis needs to be combined with the results of pathology and immunohistochemistry. Radical resection is the preferred treat.ment method, which also affects SFT. the most important prognostic factor.