骨的惡性纖維組織細(xì)胞瘤診治分析.doc

《骨的惡性纖維組織細(xì)胞瘤診治分析.doc》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。

1、骨的惡性纖維組織細(xì)胞瘤診治分析作者：千建榮　李建民　謝飛彬　楊志平　李昕【摘要】　　［目的］探討骨的惡性纖維組織細(xì)胞瘤的臨床特點(diǎn)、診斷及治療方法。［方法］回顧性分析52例骨的惡性纖維組織細(xì)胞瘤患者的臨床資料，包括發(fā)病部位、術(shù)前影像學(xué)檢查、穿刺活檢、腫瘤外科分期、治療方法以及隨訪結(jié)果等。［結(jié)果］52例患者腫瘤位于膝關(guān)節(jié)周圍32例、肩關(guān)節(jié)周圍14例、股骨近端3例，跟骨、腰椎、髂骨各1例。術(shù)前常規(guī)行X線片、CT及MRI，并行穿刺活檢。根據(jù)Enneking腫瘤外科分期，20例屬于ⅡA期，32例屬于ⅡB期。所有病例除1例保守治療外，其余均行手術(shù)治療，以保肢術(shù)為主，保肢率74.5％（38／51），同時(shí)進(jìn)

2、行術(shù)前、術(shù)后化療及術(shù)后放療。36例患者經(jīng)過長期隨訪，隨訪率69.2％（36／52），其中局部復(fù)發(fā)9例，遠(yuǎn)處轉(zhuǎn)移6例，5年生存率61.1％（22／36）。［結(jié)論］術(shù)前穿刺活檢結(jié)合影像學(xué)檢查對惡性纖維組織細(xì)胞瘤的診斷有很大幫助，治療以保肢手術(shù)為主，術(shù)前、術(shù)后化療以及術(shù)后放療可以防止腫瘤復(fù)發(fā)，腫瘤的徹底切除是骨的惡性纖維組織細(xì)胞瘤治愈的關(guān)鍵?！娟P(guān)鍵詞】骨的惡性纖維組織細(xì)胞瘤　保肢術(shù)　放療　化療　　Diagnosisandtreatmentofmalignantfibroushistiocytomaofbone　　Abstract：［Objective］Toapproachtheclinicalch

3、aracteristic,diagnosisandmethodoftreatmentofmalignantfibroushistiocytomaofbone.［Method］Theclinicaldataof52patientsofmalignantfibroushistiocytomaofbonewereanalyzedretrospectively,includingsitesoftumor,preoperativeimageology,puncturingbiopsy,surgicalstagingoftumor,methodsoftreatment,resultsoffollowu

4、p,andsoon.［Result］Inall52casesofmalignantfibrousbistiocytomaofbone,32caseswereinperipheryofkneejoint,14casesinperipheryofshoulderjoint,3casesintheproximalfemur,1caseincalcaneus,1caseinlumbarand1caseinilium.Thepreoperativeimageelogyandpuncturingbiopsyweremadeasusual.Therewere20casesinstagingofⅡAand3

5、2casesininstagingofⅡBaccordingtoEnnekingssurgicalstagingoftumor.Allcaseswereperformedoperationexceptof1case.Theoperationweremadesalvagelimbmosflyandtheratiooflimbsalvagewas74.5%（38/51）.Thepreoperativeandpostoperativechemotherapyandradiotherapywereperformedatthesametime.Thirtysixofallcaseswereinlo

6、ngtimefollowupandtheratiooffollowupwas69.2%（36/52）.Ninecaseswererecurredintheregion,6caseshaddistantmetastasisandsurvivalrateof5yearswas61.1%（22/36）.［Conclusion］Preoperativepuncturingbiopsyandimageologycanhelpthediagnosisofmalignantfibroushistiocytomaofbone.Surgeryistheprimarymethodandradiothera

7、py6andchemotherapycanpreventtherecurrenceofthetumor.Theresectionofthetumorthoroughisthekeypointofhealingofmalignantfibroushistiocytomaofbone.　　Keywords：malignantfibroushistiocytomaofbone;limbsalvageoperatio