140例恶性外周神经鞘瘤的临床病理特征与预后影响因素分析

发布时间：2018-03-11 03:18

  本文选题：恶性外周神经鞘瘤　切入点：临床病理特征　出处：《北京协和医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨恶性外周神经鞘瘤(MPNST)患者的临床病理特征及其预后因素。方法回顾性分析1999年1月至2016年1月中国医学科学院肿瘤医院收治的140例MPNST患者的临床资料,其中男性66例,女性74例,中位发病年龄40岁。生存分析采用Kaplan-Meier法,并行Log rank检验,多因素分析采用Cox比例风险回归模型。结果全组患者的中位随访时间为43个月,3年和5年生存率分别为56.4%和48.6%,3年局部复发率为42.9%,3年远处转移率为49.3%。单因素分析显示,MPNST患者的5年生存率与肿瘤部位、深度、AJCC分期、S-100的标记状况、Ki-67指数、手术切缘状态以及是否放疗有关(均P0.05)。MPNST患者的3年局部复发率与肿瘤部位、深度、AJCC分期、S-100标记状态、Ki-67指数、手术切缘状态、是否放疗、是否化疗有关(均P0.05)。MPNST患者的3年远处转移率与肿瘤部位、大小、深度、AJCC分期、S-100标记状况、Ki-67指数、手术切缘状态有关(均P0.05)。多因素分析显示,肿瘤AJCC分期、S-100标记状况是影响MPNST患者5年总生存的独立因素(均P0.05)。肿瘤部位、Ki-67指数、是否化疗是影响MPNST患者局部复发的独立因素(均P0.05)。肿瘤深度、大小、AJCC分期、Ki-67指数是影响MPNST患者发生远处转移的独立因素(均P0.05)。结论MPNST患者的预后较差。影响MPNST患者预后的因素较多,肿瘤AJCC分期较晚、S-100阴性的患者5年生存率较低;肿瘤位于头颈、Ki-67指数≥20%、未行化疗的患者易复发;肿瘤5cm、AJCC分期较晚、手术切缘阳性、Ki-67指数≥20%的患者易发生远处转移。
[Abstract]:Objective to investigate the clinicopathological features and prognostic factors of malignant peripheral neurilemmoma (MPNST). Methods the clinical data of 140 MPNST patients admitted to the Cancer Hospital of the Chinese Academy of Medical Sciences from January 1999 to January 2016 were retrospectively analyzed, including 66 males. The median age of onset was 40 years old in 74 female patients. Survival analysis was performed with Kaplan-Meier method and Log rank test. Results the median follow-up time was 43 months, the 3-year and 5-year survival rates were 56.4% and 48.6 respectively, the 3-year local recurrence rate was 42.9%, and the 3-year distant metastasis rate was 49.3%. The 5-year survival rate and tumor site of patients with MPNST, The marked status of S-100 in AJCC staging was Ki-67 index, surgical margin status and whether radiotherapy was relevant (all P0.05. MPNST patients had 3 years local recurrence rate and tumor site, depth AJCC staging and S-100 labeled status of Ki-67 index, surgical margin status, radiotherapy or not. Whether chemotherapy-related (all P0.05, MPNST, 3-year distant metastasis rate was associated with tumor location, size, depth of AJCC staging and S-100 labeling status and Ki-67 index, surgical margin status were correlated (all P 0.05). Multivariate analysis showed that, S-100 labeling status in AJCC staging was an independent factor (all P 0.05) to affect the overall survival of MPNST patients in 5 years. Ki-67 index of tumor site and whether chemotherapy was an independent factor affecting local recurrence in MPNST patients (all P0.05. tumor depth). Ki-67 index was an independent factor influencing distant metastasis in patients with MPNST (P 0.05). Conclusion the prognosis of patients with MPNST is worse than that of patients with MPNST. The 5-year survival rate of patients with AJCC stage is lower than that of patients with negative AJCC staging. The tumor was located in the head and neck with Ki-67 index 鈮，

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