Solitary Fibrous Tumor/Hemangiopericytoma of Spinal Cord: A Retrospective Single-Center Study of 16 Cases
Solitary Fibrous Tumor/Hemangiopericytoma of Spinal Cord: A Retrospective Single-Center Study of 16 Cases
复制标题
脊髓孤立性纤维瘤/血管外皮细胞瘤：16例单中心回顾性研究
DOI：
10.1016/j.wneu.2018.12.004
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发表时间：
2019-03-01
影响因子：
2
通讯作者：
Lei, Ting
中科院分区：
文献类型：
--
作者：
Wang, Junwen;Zhao, Kai;Lei, Ting
目的：在这项研究中，我们回顾性总结了我们的经验，在手术治疗孤立性纤维瘤（SFT）/血管外皮细胞瘤（HPCs）的脊髓。方法：16例SFT/HPCs的脊髓纳入本研究。回顾性审查了临床表现、放射学发现、组织病理学特征、手术治疗、辅助治疗和预后的数据。Kaplan-Meier曲线和log-rank检验用于确定复发和总生存期（OS）的预后因素。结果：我们的系列包括6名男性和10名女性，男女比例为1：1.7。磁共振成像（MRI）显示所有16例患者在T2加权图像上均出现轻微高信号病变。所有肿瘤均显示信号转导子和转录激活子6的免疫组化染色阳性。临床资料的统计学分析显示，年龄、性别、肿瘤部位、肿瘤大小、髓腔部位和Ki-67指数与复发和OS无关（P > 0.05）。而WHO分级Ⅲ级与复发显著相关（P < 0.01）。大体全切除术（GTR）和术后放疗可显著降低复发率（P < 0.01和P < 0.05），但仅GTR可显著提高OS（P < 0.05）。MRI T2加权像高信号结合信号转导子和转录激活子6免疫组化染色阳性是这些肿瘤分类和鉴别诊断的重要线索。手术切除范围、WHO分级、术后放疗可能是复发的预测因素。应尽可能寻求完全肿瘤切除，并建议手术切除后进行辅助放疗。此外，定期和长期的后续行动是强制性的，以监测复发。
OBJECTIVE: In this study, we retrospectively reviewed our experience in the surgical management of solitary fibrous tumor (SFT)/hemangiopericytomas (HPCs) of the spinal cord.METHODS: Sixteen patients with SFT/HPCs of the spinal cord were enrolled in this study. Data on clinical presentation, radiologic findings, histopathologic features, surgical treatment, adjuvant therapy, and prognosis were retrospectively reviewed. Kaplan-Meier curves and log-rank tests were used to identify the prognostic factors for recurrence and overall survival (OS).RESULTS: Our series included 6 men and 10 women, with a male/female ratio of 1:1.7. Magnetic resonance imaging (MRI) showed slightly hyperintense lesions on T2-weighted images for all 16 patients. All tumors showed positive immunohistochemical staining for signal transducer and activator of transcription 6. Statistical analysis of clinical data showed that age, gender, tumor location, tumor size, medullary compartment location, and Ki-67 index were not associated with recurrence and OS (P > 0.05). However, World Health Organization grade III was significantly associated with recurrence (P < 0.01). Gross total resection (GTR) and postoperative radiotherapy significantly reduced recurrence (P < 0.01 and P < 0.05), but only GTR showed remarkable benefits to improve OS (P < 0.05).CONCLUSIONS: SFT/HPCs of spinal cord are rare neoplasms with a propensity to recur. Hyperintensity on T2-weighted magnetic resonance imaging combined with positive immunohistochemical staining for signal transducer and activator of transcription 6 are important clues for classification and differentiation of these tumors. The extent of resection, World Health Organization grade, and postoperative radiotherapy might be predictive factors for recurrence. Complete tumor resection should be sought whenever possible, and adjuvant radiotherapy is recommended after surgical resection. Moreover, regular and long-term follow-up is mandatory to monitor recurrence.