Liposarcoma A study of 55 cases with a reassessment of its classification
Liposarcoma A study of 55 cases with a reassessment of its classification
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脂肪肉瘤55例研究及其分类重新评估
DOI：
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发表时间：
1979
影响因子：
5.6
通讯作者：
Harry L. Evans
中科院分区：
文献类型：
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作者：
Harry L. Evans
本文对55例脂肪肉瘤进行了回顾性分析。根据组织病理学检查结果对这些病例进行分类如下：粘液样，29例;高分化，11例;去分化，8例;多形性，4例;高分化和多形性结合，2例;未分类，1例。“去分化脂肪肉瘤”一词是指肿瘤中含有不同区域的分化良好的脂肪肉瘤和细胞非脂肪生成的梭形细胞或多形性肉瘤。除1例外，所有患者均为成人。粘液样和多形性脂肪肉瘤主要发生在大腿，而高分化、去分化和高分化多形性脂肪肉瘤合并表现出对腹膜后的明显偏好。多形性和去分化型脂肪肉瘤患者的生存率明显低于粘液样和高分化型。在所有类型中有明显的局部复发倾向。复发性粘液样和多形性脂肪肉瘤经常通过额外的治疗得到控制，而其他类型的复发通常不能;这种差异被认为主要是位置因素的结果。粘液样脂肪肉瘤10例，多形性脂肪肉瘤3例，去分化脂肪肉瘤2例。在粘液样脂肪肉瘤中，与单纯切除术相比，切除后放疗的初始治疗可显著降低局部复发率，与单纯切除术相比，局部复发范围更广，更广泛的高细胞区与转移潜能增加相关。“圆细胞”脂肪肉瘤并不是一个独立的类型;所有可能被认为是这种命名的病例都可以更好地分类为具有细胞区域的粘液样脂肪肉瘤（通常）或具有圆形细胞的多形性脂肪肉瘤（罕见）。某些去分化和多形性脂肪肉瘤的部分与“纤维组织细胞瘤”的相似性足以否认后者组织学模式的特异性。
Fifty-five cases of liposarcoma were reviewed. The cases were classified on the basis of histopathologic findings as follows: myxoid, 29 cases; well-differentiated, 11 cases; dedifferentiated, eight cases; pleomorphic, four cases; combined well-differentiated and pleomorphic, two cases; and unclassified, one case. The term “dedifferentiated liposarcoma” is proposed for tumors containing distinct areas of well-differentiated liposarcoma and cellular nonlipogenic spindle-cell or plemorphic sarcoma. All patients except one were adults. Myxoid and plemorphic liposarcoma predominantly involved the thigh, while well-differentiated, dedifferentiated, and combined well-differentiated-plemorphic liposarcoma showed a marked preference for the retroperitoneum. The survival of patients with pleomorphic and dedifferentiated liposarcoma was significantly poorer than that of those with the myxoid and well-differentiated varieties. There was a marked tendency toward local recurrence in all types. Recurrent myxoid and pleomorphic liposarcomas were often controlled by additional therapy, whereas recurrences of other types usually were not; this difference was considered largely a result of locational factors. Metastasis was observed in 10 cases of myxoid liposarcoma, three of plemorphic liposarcoma, and two of dedifferentiated liposarcoma. In myxoid liposarcoma, initial treatment consisting of excision followed by radiation resulted in a significantly reduced rate of local recurrence as compared with excision alone, and more extensive as compared with excision alone, and more extensive hypercellular zones were associated with increased metastatic potential. “Round cell” liposarcoma was not found to be an independent type; all cases for which this designation might have been considered could be better classified as myxoid liposarcoma with cellular areas (usually) or plemorphic liposarcoma with rounded cells (rarely). The resemblance of portions of some dedifferentiated and plemorphi liposarcomas to “malignat fibrous histocytoma” was sufficient to deny the specificity of the histologic pattern of the latter.