泌尿生殖系統(tǒng)孤立性纖維瘤20例分析

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Urogenital solitary fibrous tumor：a review of 20 cases

SHEN Hongwei JIANG Bo WANG Xin JI Changwei DENG Yongming ZHANG Shiwei GUO Hongqian 2

ABSTRACT：Objective To explore the diagnosis，treatment，prognosis and long-term follow-up of urogenital solitary fibrous tumor （SFT） and to differentiate the characteristics between benign and malignant SFT.Methods Clinical data of 20 patients with urogenital SFT treated in our hospital during Jan.2004 and Aug.2021 were respectively analyzed，including the general characteristics，clinical symptoms，imaging results，treatment methods，pathological results，and long-term follow-up results.Results Of the 20 cases，9 cases had tumor in kidney，7 in pelvic cavity，3 in bladder and 1 in prostate.Six patients showed non-specific clinical symptoms，including lower extremity weakness，urodynia，dysuria，frequent urination with changes in stool habits，low back pain，and abdominal wall mass with abdominal pain，and the other 14 cases were asymptomatic.The median diameter of SFT was 5.2 cm （range：1.7-15.0 cm）.All patients received surgical treatment，including robotic-assisted surgery in 8 cases，open surgery in 5 cases，laparoscopic surgery in 5 cases，and transurethral resection of tumor in 2 cases.CT plain scan showed high，low and mixed density soft tissue masses，and enhanced CT showed enhanced results.Pathology results revealed frequent nuclear divisions，morphological variations and necrosis in malignant SFT，which had higher expression of Ki-67 than benign SFT.The results of the modified Demicco prognostic risk stratification model showed that all malignant SFT cases were at intermediate risk. The DFS of the SFT radical tumor resection group was slightly longer than that of the simple tumor resection group but the difference was not statistically significant （P=0.203）.Conclusion Markers such as CD3 Bcl STAT6 and CD99 are used to diagnose SFT，while Ki-67 and tumor necrosis are used to differentiate benign and malignant SFT.The modified Demicco prognostic risk stratification model plays an important role in predicting the prognosis of SFT.Surgical resection is the most common treatment with excellent prognosis.In addition，benign SFT has much better prognosis than malignant case.

KEY WORDS：urogenital system；solitary fibrous tumor；follow-up；tumor markers；surgery；pathology

摘要：目的 探討泌尿生殖系統(tǒng)孤立性纖維瘤（SFT）的診斷、治療、長(zhǎng)期隨訪結(jié)果，并比較良惡性SFT的特點(diǎn)。（剩余9071字）