蒋代国,王东,贺晓燕,李晓隆,刘贵忠
JIANG Daiguo,WANG Dong,HE Xiaoyan,LI Xiaolong,LIU Guizhong

• 1:贵州医科大学附属肿瘤医院骨科

摘要(Abstract)：

目的 探讨四肢脂肪肉瘤患者的病理、影像学特征，分析影响患者无进展生存的独立危险因素。方法 收集50例四肢脂肪肉瘤患者资料，分析治疗前核磁共振影像特点，观察手术切除标本的组织病理类型、分级及Ki-67表达；采用单因素方差分析患者性别、年龄、脂肪肉瘤的病理类型、肿瘤大小、侵及深度、疾病分期、治疗方式、Ki-67表达水平及进展生存时间的差异，并对有差异的指标采用Cox回归分析，评估患者预后独立影响因素。结果 患者平均年龄(49.24±11.01)岁，肿瘤大小0.5～22 cm,发病部位下肢44例、上肢6例；病理类型包括黏液性、多形性、高分化和去分化，去分化和多形性患者增殖细胞抗原Ki-67阳性表达率高于黏液性和高分化患者(P<0.05);单因素分析显示，四肢脂肪肉瘤患者3年无进展生存与肿瘤大小和年龄相关(P<0.05),5年无进展生存与治疗方式相关(P<0.05);多因素分析结果显示，肿瘤大小是四肢脂肪肉瘤患者3年无进展生存的独立影响因素，疾病分期是四肢脂肪肉瘤患者5年无进展生存的独立影响因素。结论 四肢脂肪肉瘤的大小是肿瘤患者3年无进展生存率的相关因素，肿瘤的病理分级是患者术后5年无进展生存率的相关因素。
Objective To investigate the pathological and radiological characteristics of patients with extremity liposarcoma, and to analyze the independent risk factors affecting the patients' progression-free survival. Methods Data from 50 patients with extremity liposarcoma were collected, and the characteristics of pre-treatment magnetic resonance imaging, the histopathological types and grading of surgical resection specimens, and proliferating cell antigen Ki-67 expression were analyzed. Univariate analysis of variance was used to analyze the differences in patient gender, age, pathological type of liposarcoma, tumor size, invasion depth, disease stage, treatment method, Ki-67 expression level, and progression-free survival time. Cox regression analysis was used to evaluate the independent prognostic factors for patients with significant differences. Results The average age of the patients was(49.24±11.01) years, and the tumor size ranged from 0.5 to 22 cm. The disease occurred in the lower limbs in 44 cases and in the upper limbs in 6 cases. The pathological types included mucinous, pleomorphic, well-differentiated, and dedifferentiated. The positive expression rate of Ki-67 in patients with dedifferentiated and pleomorphic was higher than that in patients with mucinous and well-differentiated(P<0.05). Univariate analysis showed that the 3-year progression-free survival of patients with extremity liposarcoma was related to tumor size and age(P<0.05), and the 5-year progression-free survival was related to the treatment method(P<0.05). Multivariate analysis results showed that tumor size was an independent influencing factor for the 3-year progression-free survival of patients with extremity liposarcoma, and disease stage was an independent influencing factor for the 5-year progression-free survival of patients with extremity liposarcoma. Conclusion The size of extremity liposarcoma is a related factor for the 3-year progression-free survival rate of tumor patients, and the pathological grading of the tumor is a related factor for the 5-year progression-free survival rate of patients after surgery.

关键词(KeyWords)： 四肢脂肪肉瘤;病理特征;影像学特征;免疫组织化学;单因素分析;多因素分析
extremity liposarcoma;pathological characteristics;radiological characteristics;immunohistochemistry;univariate analysis;multivariate analysis

Abstract:

Keywords:

基金项目(Foundation): 2021年贵州卫生健康委科学技术基金项目(gzwkj2021-264)

作者(Author): 蒋代国,王东,贺晓燕,李晓隆,刘贵忠
JIANG Daiguo,WANG Dong,HE Xiaoyan,LI Xiaolong,LIU Guizhong

DOI: 10.19367/j.cnki.2096-8388.2023.09.015

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