摘要
目的探讨头颈部滑膜肉瘤的病理学特点、治疗方法及预后。方法回顾性分析2012年1月至2020年12月郑州大学第一附属医院收治的24例头颈部滑膜肉瘤患者的临床资料,其中男性16例,女性8例,年龄17~75岁。总结其病理学特点、治疗及随访情况。采用Kaplan-Meier法估计患者累积生存率。结果所有患者均经病理确诊,镜下多由梭形细胞组成,表现出恶性肿瘤细胞的特性,部分还可见上皮样细胞形态,形成双相分化的典型病理特征。24例患者中除1例因无法耐受手术仅行活检确诊外,余23例均行手术治疗,其中单纯手术治疗3例,术后辅助放疗5例,术后辅助化疗7例,术后辅助放化疗8例。随访时间为3.0~114.1个月,中位随访时间为25.2个月,失访2例;复发10例,肺转移5例,骨转移1例;死亡12例。患者1年、3年、5年累积生存率分别为74.4%、58.9%和39.2%。结论头颈部滑膜肉瘤复发率高,常远处转移,预后差。病理组织学和免疫组织化学检查是重要诊断依据,治疗以手术切除为主,尽可能行根治或扩大切除。
Objective To investigate the pathological characteristics,treatment and prognosis of synovial sarcoma of head and neck.Methods The clinical data of 24 patients with synovial sarcoma of the head and neck treated in the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2020 were retrospectively analyzed.There were 16 males and eight females,aged 17 to 75 years.The pathological features,treatment and follow-up were summarized.Cumulative survival was estimated by Kaplan-Meier method.Results All patients′diagnoses were confirmed by pathological examinations.Most cases showed the tumors were composed of spindle cells under microscope,with the characteristics of malignant tumor cells,and some tumors also showed epithelioid cell morphology,forming the typical pathological characteristics of biphasic differentiation.Except for one patient who could not tolerate surgery and the diagnosis was only confirmed by biopsy,the remaining 23 patients received surgical treatment,including three patients receiving surgical treatment alone,five patients receiving post-operative adjuvant radiotherapy,seven patients receiving post-operative adjuvant chemotherapy,and eight patients receiving post-operative adjuvant radiotherapy.Follow-up time was 3.0-114.1 months(median follow-up time:25.2 months),including two cases of loss to follow-up,10 cases of recurrence,five cases of lung metastases,one case of bone metastasis,and 12 cases of death.The 1-year,3-year and 5-year survival rates for the 24 patients with synovial sarcoma of head and neck were 74.4%,58.9%and 39.2%,respectively.Conclusion Synovial sarcoma of the head and neck has a high recurrence rate,common distant metastasis and poor prognosis.Histopathology and immunohistochemical examinations are an important basis for diagnosis,if necessary,combined with molecular genetics.Surgical resection is the main treatment,preferring radical or expanded resection.
作者
郭相岑
王军玲
刘丽
桑建中
曹华
Guo Xiangcen;Wang Junling;Liu Li;Sang Jianzhong;Cao Hua(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Otorhinolaryngology Head and Neck Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China;Department of Medicine,Henan Medical College,Zhengzhou 451191,China)
出处
《中华耳鼻咽喉头颈外科杂志》
CSCD
北大核心
2022年第7期854-859,共6页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
头颈部肿瘤
滑膜肉瘤
病理学
治疗
预后
Head and neck neoplasms
Synovial sarcoma
Pathology
Treatment
Prognosis
