中国普外基础与临床杂志

中国普外基础与临床杂志

结肠未分化多形性肉瘤诊治分析(附 3 例报道及文献复习)

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目的 探讨结肠未分化多形性肉瘤的临床特征及治疗方式。 方法 回顾性分析了笔者所在医院 1983 年 10 月至 2016 年 7 月期间共收治的 3 例结肠未分化多形性肉瘤患者以及文献报道的 23 例结肠未分化多形性肉瘤患者的临床病理资料。 结果 笔者所在医院的 3 例结肠未分化多形性肉瘤患者均接受了手术治疗,2 例于术后行放疗。3 例分别于术后 5 个月、3 年及 5 年因复发或转移而死亡。文献报道的 23 例结肠未分化多形性肉瘤患者除 1 例外均行手术治疗,有 2 例于术后行了化疗,有 15 例术后未行辅助治疗,有 6 例未见明确报道。16 例患者有随访结果,其中 9 例患者无复发转移,7 例患者死亡。 结论 结肠未分化多形性肉瘤无特异性临床表现,其预后差,手术治疗为目前的主要治疗方式,早期、完整切除肿瘤是手术治疗的核心。术后可采取放疗、化疗等辅助治疗,治疗效果及方案选择仍待进一步研究。

Objective To explore clinical characteristics and therapeutic strategy of undifferentiated pleomorphic sarcoma of colon. Methods A retrospective study of 3 patients with undifferentiated peomorphic sarcoma of the colon was conducted. These cases were treated at the Peking Union Medical College Hospital from October 1983 to July 2016. In addition, the clinicopathologic data of 23 patients with undifferentiated pleomorphic sarcoma of colon reported in the literatures were analyzed. Results These 3 cases all received surgery in our hospital, including two patients who received postoperative radiotherapy. These three cases died of the local relapse or metastasis respectively at 5 months, 3 years, and 5 years after surgery. The 23 patients reported in the literatures were treated surgically except for 1 case, of which received chemotherapy after operation in the 2 cases, did not receive adjuvant therapy after operation in the 15 cases, were not reported clearly in the 6 cases. Sixteen cases had the results of follow-up, of which 9 cases had no recurrences or metastases and 7 cases died. Conclusions Undifferentiated pleomorphic sarcoma of colon has no specific clinical manifestation, it’s prognosis is very poor. Surgery is a main treatment for it at present. Thorough resection of tumor at an early stage is essential to patient’s recovery. Treatments such as chemotherapy and radiotherapy could be selected as postoperative adjuvant treatment, however, therapeutic schemes and effectiveness need further to be studied.

关键词: 结肠; 未分化多形性肉瘤; 手术; 放疗; 化疗

Key words: colon; undifferentiated pleomorphic sarcoma; surgery; radiotherapy; chemotherapy

引用本文: 崔铭, 廖泉, 王文泽, 赵玉沛. 结肠未分化多形性肉瘤诊治分析(附 3 例报道及文献复习). 中国普外基础与临床杂志, 2018, 25(4): 410-415. doi: 10.7507/1007-9424.201710069 复制

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1. Sewell R, Levine BA, Harrison GK, et al. Primary malignant fibrous histiocytoma of the intestine: intussusception of a rare neoplasm. Dis Colon Rectum, 1980, 23(3): 198-201.
2. Levinson MM, Tsang D. Multicentric malignant fibrous histiocytomas of the colon. Report of a case and review of the subject. Dis Colon Rectum, 1982, 25(4): 327-331.
3. Rubbini M, Marzola A, Spanedda R, et al. Primary malignant fibrous histiocytoma of the sigmoid colon: a case report. Ital J Surg Sci, 1983, 13(4): 299-302.
4. Waxman M, Faegenburg D, Waxman JS, et al. Malignant fibrous histiocytoma of the colon associated with diverticulitis. Dis Colon Rectum, 1983, 26(5): 339-343.
5. Kukora JS, Bagnato J, Gatling R. Fibrous histiocytoma of colon and pancreas: report of 2 unusual cases and review of the literature. Dig Surg, 1985, 2: 180-184.
6. Baratz M, Ostrzega N, Michowitz M, et al. Primary inflammatory malignant fibrous histiocytoma of the colon. Dis Colon Rectum, 1986, 29(7): 462-465.
7. Yahagi K, Arai T, Matsumoto J, et al. Malignant fibrous histiocytoma of the colon with marked stenosis report of a case. Stomach Intestine, 1986, 21: 215-219.
8. Satake T, Matsuyama M. Cytologic features of ascites in malignant fibrous histiocytoma of the colon. Acta Pathol Jpn, 1988, 38(7): 921-928.
9. Katz RN, Waye JD, Batzel EL, et al. Malignant fibrous histiocytoma of the gastrointestinal tract in a patient with neurofibromatosis. Am J Gastroenterol, 1990, 85(11): 1527-1530.
10. Murata I, Makiyama K, Miyazaki K, et al. A case of inflammatory malignant fibrous histiocytoma of the colon. Gastroenterol Jpn, 1993, 28(4): 554-563.
11. Huang Z, Wei K. Malignant fibrous histiocytoma of the ascending colon in a child. Am J Gastroenterol, 1993, 88(6): 972-973.
12. Makino M, Kimura O, Kaibara N. Radiation-induced malignant fibrous histiocytoma of the transverse colon: case report and review of the literature. J Gastroenterol, 1994, 29(6): 767-771.
13. Hiraoka N, Mukai M, Suzuki M, et al. Malignant fibrous histiocytoma of the cecum: report of a case and review of the literature. Pathol Int, 1997, 47(10): 718-724.
14. Udaka T, Suzuki Y, Kimura H, et al. Primary malignant fibrous histiocytoma of the ascending colon: report of a case. Surg Today, 1999, 29(2): 160-164.
15. 周建平, 苏东明, 李继光, 等. 结肠恶性纤维组织细胞瘤一例. 中华胃肠外科杂志, 2001, 4(4): 227.
16. 武海生. 回盲部恶性纤维组织细胞瘤 1 例. 承德医学院学报, 2005, 22(1): 78-78.
17. Gupta C, Malani AK. Primary malignant fibrous histiocytoma of the colon. Clin Gastroenterol Hepatol, 2006, 4(6): xxviii.
18. Bosmans B, de Graaf EJ, Torenbeek R, et al. Malignant fibrous histiocytoma of the sigmoid: a case report and review of the literature. Int J Colorectal Dis, 2007, 22(5): 549-552.
19. Fu DL, Yang F, Maskay A, et al. Primary intestinal malignant fibrous histiocytoma: two case reports. World J Gastroenterol, 2007, 13(8): 1299-1302.
20. 柳维军, 陈泽, 奉孝荣. 回盲部恶性纤维组织细胞瘤临床病理观察. 实用医院临床杂志, 2010, 7(3): 130-131.
21. 刘波, 王聪, 王琳. 结肠恶性纤维组织细胞瘤伴腹膜后巨大脂肪瘤 1 例. 医学信息 (中旬刊), 2011, 24(3): 970-971.
22. 徐晓, 欧阳斌燊, 路名芝, 等. 横结肠原发多形性恶性纤维组织细胞瘤/未分化高级别多形性肉瘤 1 例. 临床与实验病理学杂志, 2012, 28(2): 231-232.
23. 张逸, 张继, 田为中. 结肠恶性纤维组织细胞瘤一例. 中华临床医师杂志 (电子版), 2013, (15): 7288.
24. 王坚, 朱雄增. 2013 版 WHO 软组织肿瘤新分类解读. 中华病理学杂志, 2013, 42(6): 363-365.
25. Ozzello L, Stout AP, Murray MR. Cultural characteristics of malignant histiocytomas and fibrous xanthomas. Cancer, 1963, 16: 331-344.
26. Nascimento AF, Raut CP. Diagnosis and management of pleomorphic sarcomas (so-called "MFH") in adults. J Surg Oncol, 2008, 97(4): 330-339.
27. Zagars GK, Mullen JR, Pollack A. Malignant fibrous histiocytoma: outcome and prognostic factors following conservation surgery and radiotherapy. Int J Radiat Oncol Biol Phys, 1996, 34(5): 983-994.
28. Weiss SW, Enzinger FM. Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer, 1978, 41(6): 2250-2266.