Deep-seated, well differentiated lipomatous tumors of the chest wall and extremities - The role of cytogenetics in classification and prognostication
Deep-seated, well differentiated lipomatous tumors of the chest wall and extremities - The role of cytogenetics in classification and prognostication
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DOI：
10.1002/cncr.20779
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发表时间：
2005-01-15
期刊：
影响因子：
6.2
通讯作者：
Rubin, BP
中科院分区：
文献类型：
--
作者：
Bassett, MD;Schuetze, SM;Rubin, BP
背景肌内脂肪瘤和非典型脂肪瘤（ALT）是胸壁和四肢常见的深部脂肪瘤。仅根据组织学分析很难区分这两种实体。然而，ALT和肌内脂肪瘤的细胞遗传学特征是不同的。正确的分型很重要，因为ALT患者的侵袭性局部疾病复发率高于肌内脂肪瘤患者。作者检查了他们的单一机构经验，并将其分类与临床特征和结果相关联。方法.在目前的研究中，106例胸壁和四肢的深位、分化良好的脂肪瘤患者采用组织学和细胞遗传学的联合方法（如果可用）被分类为ALT或肌内脂肪瘤。分类与临床病理特征和随访资料相关。55例患者被归类为肌内脂肪瘤，51例被归类为ALT。分类与年龄和性别无关（分别为P = 0.28和P = 0.96）。肌内脂肪瘤比ALT小（P < 0.0001），但两组之间存在显著重叠。ALT发生于下肢（P < 0.0009）。四肌内脂肪瘤患者和ALT患者局部复发率分别为10%和27%（P = 0.0006）。疾病复发与患者诊断时的年龄、患者性别、肿瘤大小和肿瘤位置无关（分别为P = 0.45、P = 0.26、P = 0.49和P = 0.28）。在ALT患者亚组中，疾病复发与患者诊断时的年龄、患者性别或肿瘤部位无关（分别为P = 0.38、P = 0.54和P = 0.86）。采用组织学和细胞遗传学相结合的方法对四肢和胸壁的深层次、分化良好的脂肪瘤性肿瘤进行分类，与生物学行为/疾病复发相关性良好。提倡这种联合方法，以便更好地对患者进行分层，以达到治疗目的和随访。(C)2004年美国癌症协会。
BACKGROUND. intramuscular lipomas and atypical lipomatous tumors (ALT) are common deep-seated lipomatous tumors of the chest wall and extremities. Distinguishing between these two entities can be difficult based on histologic analysis alone. However, the cytogenetic profiles of ALT and intramuscular lipomas are distinct. Correct classification is important, because aggressive local disease recurrence Occurs more frequently in patients with ALT than in patients with intramuscular lipoma. The authors examined their single institutional experience and correlated their classification with clinical features and outcome. METHODS. in the Current study, 106 patients with deep-seated, well differentiated adipose tumors of the chest wall and extremities were classified as having ALT or intramuscular lipoma using a combined approach of histology and cytogenetics, if available. The classification was correlated with clinicopathologic features and follow-up data.RESULTS. Fifty-five patients were classified as having intramuscular lipoma and 51 were classified as having ALT. Classification did not correlate with age and gender (P = 0.28 and P = 0.96, respectively). Intramuscular lipomas were smaller than ALTs (P < 0.0001), but there was significant overlap between the 2 groups. ALT occurred preferentially in the lower extremity (P < 0.0009). Four. percent of patients with intramuscular lipomas and 27% of patients with ALTs developed local disease recurrence (P = 0.0006). Disease recurrence did not correlate with patient age at diagnosis, patient gender, turner size, and tumor location (P = 0.45, P = 0.26, P = 0.49, and P = 0.28, respectively). Within the subset of patients with ALTs, disease recurrence did not correlate with patient age at diagnosis, patient gender, or tumor location (P = 0.38, P = 0.54, and P = 0.86, respectively).CONCLUSIONS. Classification of deep-seated, well differentiated lipomatous tumors of the extremities and chest wall using a combined approach of histology and cytogenetics correlated well with biologic behavior/disease recurrence. This combined approach is advocated to better stratify patients for treatment purposes and follow-up. (C) 2004 American Cancer Society.