隆突性皮肤纤维肉瘤病理诊断及预后的探讨

目的 探讨隆突性皮肤纤维肉瘤（DFSP）的病理诊断及临床病理参数，增殖细胞核抗原（PCNA）表达与预后的关系。方法 应用免疫组化方法对51例隆突性皮肤纤维肉瘤CD34、PCNA的表达进行检测。并结合病理形态学观察和随访分析。结果 所有DFSP均表达CD34，组织分级，浸润深度、局部切除范围与DFSP复合率显著相关，PCNA计数标记指数平均为41.7%，PCNA高表达组复发率显著高于PCNA低表达组。结论 CD34可作为DFSP与纤维肉瘤特异的鉴别诊断指标。组织分级，浸润深度及PCNA表达可作为判断DFSP预后的指标。扩大切除范围有助于减少复发。

Pathological diagnosis and prognosis of dermatofibrosarcoma protuberans

Objective To investigate the differential diagnosis and effective prognostic indicators of dermatofibrosarcoma protuberans (DFSP) and to explore the relationship between the PCNA expression and local recurrence of the tumor. Methods Fifty-one cases of DFSP were investigated. The histopathologic changes were observed and the expression of PCNA and CD34 was detected in all the tumors with an immunohistochemical staining. Results All the tumors expressed CD34. The histologic grading, infiltrative depth and local excision ranges were significantly related to local recurrence of the tumor (p<0.01). The mean PCNA labeling index (LI) of DFSP was 41.7%. The rate of local recurrence was significantly higher in the tumor with the high LI than in the one with low LI (p<0.01). Conclusions CD34 expression can be regarded as an independent indicator for the differential diagnosis between DFSP and fibrosarcoma. The histologic grading, infiltrative depth and PCNA expression can act as effective indicators for prognosis of the patients. The rate of local recurrence is lower in the tumor treated by wide local excision.