促结缔组织增生性小圆细胞肿瘤临床特点及治疗方案的分析研究

发布时间：2018-03-10 07:26

本文选题：促纤维组织增生性小圆细胞肿瘤　切入点：促结缔组织增生性小圆细胞肿瘤　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨促结缔组织增生性小圆细胞肿瘤(DSRCT)的病理临床特点和最佳治疗模式。方法:收集1989年有报道以来至2016年4月1日国内报道的所有文献。共筛检病例文献134篇。剔除综述类文献及重复报道的案例,共纳入87篇文献,125例患者(其中纳入预后分析65例)。对其进行统计分析。结果:125例患者中男性87例,女性38例,男女之比2.3:1;发病年龄4-83岁不等,平均年龄27.09±2.78岁。首发症状多为疼痛、自觉肿物及排便习惯改变。发病部位以盆腹腔为主,大多数患者为多发,但单发患者完全切除率高,预后相对较好。细胞具有多向表达的特点,大多数病例Des、Ker、Vim、NSE、EMA五类免疫标记物。完全手术切除肿瘤组预后优于未完全切除者,且分别优于姑息性切除者和单纯取病理者。化疗与不化疗预后无明显统计学差异,但未完全切除的患者铂剂化疗预后延长相对未化疗的患者有明显统计学意义。结论:发病倾向于20多岁年轻男性,好发于腹腔,大多发现即多发,单发者切除率高,预后明显较好,大多数病例表达结蛋白、波形蛋白、角蛋白、神经元特异烯醇化酶、上皮膜抗原五类免疫标记物,患者整体预后差,治疗上如果能完全切除,以手术完全切除为首选,化疗方案及效果有待进一步研究,但以铂剂为中心的化疗方案可能有效。
[Abstract]:Objective: to investigate the pathological clinical characteristics and optimal treatment mode of connective tissue proliferative small round cell tumor (DSRCTs). Methods: all the literatures reported from 1989 to April 1st 2016 were collected. 134 articles. Excluding the review literature and repeated reports, A total of 125 patients (including 65 patients with prognostic analysis) were included in 87 articles. Statistical analysis was carried out on them. Results 87 cases of male and 38 cases of female, the ratio of male to female were 2.3: 1, the age of onset ranged from 4 to 83 years old. The average age was 27.09 卤2.78 years old. The initial symptoms were pain, conscious masses and changes of defecation habits. The prognosis was relatively good. The cells had the characteristics of multidirectional expression. Most of the cases had a better prognosis than the patients without complete resection of the tumor, and most of the cases had five kinds of immunomarkers: the patients with complete resection of tumors had better prognosis than those with incomplete resection. It was superior to palliative resection and simple pathology respectively. There was no significant difference in prognosis between chemotherapy and non-chemotherapy. However, the prognosis of patients with incomplete resection of platinum was significantly longer than that of patients without chemotherapy. Conclusion: the incidence of platinum chemotherapy is more likely to occur in the abdominal cavity of young men than that of the patients without chemotherapy, most of them are found to be multiple, and the removal rate of single cases is high. The prognosis was obviously good. Most cases expressed desmin, vimentin, keratin, neuron-specific enolase, epithelial membrane antigen and five kinds of immunomarkers. The overall prognosis of the patients was poor. Total excision was the first choice. Chemotherapy regimen and its effect need further study, but platinum-centered chemotherapy regimen may be effective.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R730.26

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