胸膜孤立性纤维瘤的临床分析(附40例病例报道)

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1、中文摘要胸腔镜辅助手术占15．4％，仅行单纯肿瘤切除者为74．4％。随访时间2·l16．9月，平均35月，术后均未作其他辅助治疗，目前均存活，未见转移、复发，恶性者最长随访时间达到116．9月。结论：1)SFTP可发生在任何年龄，以中老年人群多见；女性发病率可能高于男性；半数肿瘤患者无症状，出现胸部症状与肿瘤大小相关，偶可出现低血糖及HPO。2)SFTP的放射影像学表现与胸内其他肿瘤无特征性区别，胸片可作为筛查及术后随访手段，胸部CT对SFTP的诊断及手术方式的决定有重要价值，M对检查并不优于胸部

2、CT。3)SFTP患者术前与术后的血糖及血液电解质在统计学上无特异性改变。4)SFTP为低度恶性肿瘤，多数起源于脏胸膜，起源于壁胸膜者少见，起源于肺实质内间质细胞者更少见，确诊依赖病理学检查及免疫组化特征。5)术前穿刺活检对SFTP的诊断有肯定的意义，完整彻底的手术切除是首选的、唯一有确切疗效的治疗方法，预后一般较好。关键词胸膜孤立性纤维瘤临床特征影像学病理治疗LiberationArmyGeneralHospital1110racicSurgeryfrom1998toMarch2010．ands

3、tatisticallyanalysistheinforrnationofclinicalfeatures．imagingcharacteristics．serumbiochemical，surgicaltreatment，pathological，immunohistochemicalfeatures，followingupaswellasthemultifacetedrelationship．Results：11Clinicalcharacteristies：Incidenceofcaseso

4、fmaleandfemaleratioWas1：1．35．andtheaverageageWas48．3years．Noclinicalsymptomsofthepatientratiois50％andtheproportionofparaneoplasticsyndromeOCCurS12．5％．Themaximumtumordiametersnotlessthanandlessthan10cmintheeventofsymptomsofpatientsweresignificantlydiff

5、erent．2)Imagingfeatures：ThepositiverateofchestX．raywas93．9％．ChestCTdiagnosticaccuracyWas63．6％．Theproportionofobviouslyenhancedcaseswas95．5％．and52．4％oftheenhancedoneswereinhomogeneous．ThevaluesofCTSCanandenhancementweresignificantlydifferentfP<0．01)．He

6、terogeneousintemalsignalaccountedfor88．9％forMRIexamination．66．7％ofthein-phase．T1．weightedsignalWasisointensity,and33．3％washypefintensity．44．4％ofthein-phase．T2．weightedsignalwashyperintensity,and11．1％washeterogeneousintensity．Thearterialphaseshowedslig

7、htandmoderateenhancement，portalphaseshowedsignificantlyenhanced，anddelayedphaseshowedcontinuingenhancement．31Laboratoryindicators：Preoperativebloodglucosevalueof5．094-1．02mmol／Landbloodglucosevalueaftersurgeryof5．304-0．78mmoI／Lwerenosignificantdiffere

8、nces．Preoperativeserumpotassiumvalueof4．104-0．21mmol／Landserumpotassiumvalueaftersurgeryof4．07士0．37mmol／Lwerenosignificantdifferences．Preoperativeserumsodiumvalueof141．9士2．46lllm01／Landserumsodiumvalueaftersurgeryof139．7士3．65mmoI／Lhadsignifica