中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2014年
2期
136-140
,共5页
运新伟%王萍萍%于洋%高明
運新偉%王萍萍%于洋%高明
운신위%왕평평%우양%고명
血管肉瘤%面部肿瘤%头皮%皮肤肿瘤%头颈部肿瘤
血管肉瘤%麵部腫瘤%頭皮%皮膚腫瘤%頭頸部腫瘤
혈관육류%면부종류%두피%피부종류%두경부종류
Hemangiosarcoma%Facial neoplasms%Scalp%Skin neoplasms%Head and neck neoplasms
目的 探讨原发于头面部的血管肉瘤临床和病理特征及治疗方法.方法 回顾性分析1993年1月至2003年1月15例原发于头面部的血管肉瘤患者的临床资料,其中男10例,女5例,肿瘤发生于头皮11例,面部4例.临床症状以局部肿物和血管瘤样改变为主.15例患者肿瘤分期为Ⅰ期6例,Ⅱ期3例,Ⅲ期1例,Ⅳ期5例.本组患者行单纯手术5例,单纯化疗3例,综合治疗5例,未治疗2例.采用Kaplan-Meier法进行生存率分析.8例患者行CD31、CD34和第Ⅷ因子相关抗原(FⅧRag)免疫组化染色检查.结果 本组患者随访3～240个月,中位随访时间28个月,无失访病例.1例Ⅰ期单纯手术治疗患者及2例Ⅰ期综合治疗患者无瘤生存,分别为121、209和240个月;1例Ⅰ期综合治疗患者带瘤生存127个月;11例患者死亡,生存时间为3～78个月,中位生存时间20个月;3年生存率为46.7％,5年生存率为33.3％.免疫组化检查8例患者CD31和CD34均为阳性,6例FⅧRAg阳性.结论 头面部血管肉瘤较少见,恶性程度高,易误诊,确诊依靠病理诊断,免疫组化检查有一定意义.血管肉瘤的治疗应采用手术切除加放、化疗为主的综合治疗模式,对于早期患者可提高其生存率.
目的 探討原髮于頭麵部的血管肉瘤臨床和病理特徵及治療方法.方法 迴顧性分析1993年1月至2003年1月15例原髮于頭麵部的血管肉瘤患者的臨床資料,其中男10例,女5例,腫瘤髮生于頭皮11例,麵部4例.臨床癥狀以跼部腫物和血管瘤樣改變為主.15例患者腫瘤分期為Ⅰ期6例,Ⅱ期3例,Ⅲ期1例,Ⅳ期5例.本組患者行單純手術5例,單純化療3例,綜閤治療5例,未治療2例.採用Kaplan-Meier法進行生存率分析.8例患者行CD31、CD34和第Ⅷ因子相關抗原(FⅧRag)免疫組化染色檢查.結果 本組患者隨訪3～240箇月,中位隨訪時間28箇月,無失訪病例.1例Ⅰ期單純手術治療患者及2例Ⅰ期綜閤治療患者無瘤生存,分彆為121、209和240箇月;1例Ⅰ期綜閤治療患者帶瘤生存127箇月;11例患者死亡,生存時間為3～78箇月,中位生存時間20箇月;3年生存率為46.7％,5年生存率為33.3％.免疫組化檢查8例患者CD31和CD34均為暘性,6例FⅧRAg暘性.結論 頭麵部血管肉瘤較少見,噁性程度高,易誤診,確診依靠病理診斷,免疫組化檢查有一定意義.血管肉瘤的治療應採用手術切除加放、化療為主的綜閤治療模式,對于早期患者可提高其生存率.
목적 탐토원발우두면부적혈관육류림상화병리특정급치료방법.방법 회고성분석1993년1월지2003년1월15례원발우두면부적혈관육류환자적림상자료,기중남10례,녀5례,종류발생우두피11례,면부4례.림상증상이국부종물화혈관류양개변위주.15례환자종류분기위Ⅰ기6례,Ⅱ기3례,Ⅲ기1례,Ⅳ기5례.본조환자행단순수술5례,단순화료3례,종합치료5례,미치료2례.채용Kaplan-Meier법진행생존솔분석.8례환자행CD31、CD34화제Ⅷ인자상관항원(FⅧRag)면역조화염색검사.결과 본조환자수방3～240개월,중위수방시간28개월,무실방병례.1례Ⅰ기단순수술치료환자급2례Ⅰ기종합치료환자무류생존,분별위121、209화240개월;1례Ⅰ기종합치료환자대류생존127개월;11례환자사망,생존시간위3～78개월,중위생존시간20개월;3년생존솔위46.7％,5년생존솔위33.3％.면역조화검사8례환자CD31화CD34균위양성,6례FⅧRAg양성.결론 두면부혈관육류교소견,악성정도고,역오진,학진의고병리진단,면역조화검사유일정의의.혈관육류적치료응채용수술절제가방、화료위주적종합치료모식,대우조기환자가제고기생존솔.
Objective To investigate the clinical and pathological characteristics of angiosarcoma of the head and face.Methods The data of 15 patients with angiosarcoma of the head and face underwent treatment between January 1993 and January 2003 were reviewed.Of 15 cases 10 were men and 5 women; 11 tumors in scalp and 4 in face ; 6 cases of stage Ⅰ,3 cases of stage Ⅱ,1 case of stage Ⅲ and 5 cases of stage Ⅳ.Clinical symptoms included a focal mass or bruiselike patches.Surgery alone in 5 cases,chemotherapy alone in 3 cases,comprehensive treatment in 5 cases,no treatment in 2 cases.Immunohistochemical staining with CD31,CD34 and FⅧRag was performed in 8 cases.Results Follow-up time was 3-240 months with a median of 28 months.One patient of stage Ⅰ by surgery alone and 2 patients of stage Ⅰ with comprehensive treatment survived for 121,209 and 240 months respectively and no recurrence.One patient of stage Ⅰ with comprehensive treatment was survival for 127 months with tumor burden.Eleven cases died in 3-78 months after diagnosis,the median follow-up time was 20 months.Three year and five year survival rates were 46.7％ and 33.3％,respectively.Immunohistochemical staining showed CD31-and CD34-positive for 8 cases and F Ⅷ Rag-positive for 6 cases.Conclusions Angiosarcoma of the head and face is a high-risk sarcoma.It is rare and easily misdiagnosed but can be diagnosed properly based on pathological feature.Comprehensive treatment including surgery,radiotherapy and chemotherapy can improve survival rate for the patients with early stage angiosarcoma.
