隆突性皮肤纤维肉瘤复发与转移的临床病理研究

本文通过46例隆突性皮肤纤维肉瘤(DFSP)的研究，发现它的特征为肿瘤位于真皮,病程长，术后局部复发率高(47．8%)、转移率较低(6．5%);多次复发率导致转移。对复发22例和转移3例的研究，并结合文献临床与病理相关因素：(1)肿瘤生长时间长，瘤体较大，无完整包膜．呈浸润性生长而不易彻底切除干净;(2)对DFSP临床病理特性了解不够常误诊为良性肿瘤，使首次手术多在门诊进行而切除不彻底;少数病例病理亦误诊为良性肿瘤，使病人失去及时作进一步扩大切除机会；(3)部分DFSP复发后瘤细胞异型和核分裂增多，并出现纤维肉瘤区域，肿瘤恶性程度增高;(4)转移者除以上因素外,还可能与局部外伤和多次复发手术致使血管、淋巴管损伤以及DFSP有侵犯血管、淋巴管潜能密切相关。

CLINICOPATHOLOGICAL STUDY OF RECURRENCE AND METASTASIS ON THE DERMATOFI- BROSARCOMA PROTUBERANS

The authors analysed 46 cases of dermatofibrosarcoma protuberans (DFSP). We had found the DFSP was characterized by occurrence in dermis, long course and a high rate of local recurrence (47. 8%), low frequency of metastasis (6. 5%). A relative clinicopathological factors of recurrence of 22 cases and metastasis of 3 cases had discussed with review literatures. These factors were as follows (1) The tumors were not easy cleanly excised because of growing large at long course, uncomplete capsule and infiltrated growth. (2)The knowledges of the clinicopathological characters for the DFSP were not fully known, such tumors were frequently an erroneously diagnosed that benign tumors were operated in clinic. It was not fully excised. On the other hand, a few patients had missed an opportunity of repeated operation because some tumors were an erroneously diagnosed benign tumors by pathologic doctors. (3)The malignancy of tumor had increased because of obvious pleomorphism and mitotic figures of tumor cells, and areas of having fibrosarcoma in some DFSP. (4) The metastatic factors not only had as indicated above three points but (also) were of local injury, vascular and lymphatic vessels injury at operating because of repeated recurrence, and DFSP had been found it was possessed of a optential ability infiltrating vascular vessels.