原发四肢软组织肉瘤的综合治疗.PDF

中国骨与关节杂志 2017 年 2 月第 6 卷第 2 期 Chinese Journal of Bone and Joint, February 2017, Vol 6, No.2 . 83 . . 专论 Special article . 原发四肢软组织肉瘤的综合治疗 白靖平 DOI: 10.3969/j.issn.2095-252X.2017.02.002　　中图分类号：R738.6 基金项目：乌鲁木齐市科学技术计划项目 ( Y141310040 ) 作者单位：830011 乌鲁木齐，新疆医科大学附属肿瘤医院骨与软组织科 Comprehensive treatment of primary extremity soft tissue sarcomas BAI Jing-ping. Department of Bone and Soft Tissue, Xinjiang Tumor Hospital, Xinjiang Medical University, Urumqi, Sinkiang, 830011, China Abstract Sarcoma is a rare solid tumor which roots in different mesenchymal cells, with distinct clinical and 【 】 pathologic features. Soft tissue sarcoma ( STS ) roots in the fat, muscles, nerves, blood vessels and other connective tissues. The pathogenesis is still unclear. In the diagnosis of STS, the combination of clinical features, imaging and pathology is emphasized. Pathologic evaluation should include the type of STS, grading and staging. Operation is given priority in the comprehensive treatment of STS. According to the pathologic evaluation, clinical stage and the relationship between STS and bones, joints and peripheral nerves and blood vessels, the surgical method is selected. The curative effects of STS could be improved by normative diagnosis and treatment. The importance of a multidisciplinary team ( MDT ) is emphasized in regional cancer center. On the basis of the high-level evidence-based medicine, individualized diagnosis and treatment is the best medical practice. Key words Extremities; Soft tissue neoplasms; Clinical protocols; Therapy 【 】 【关键词】　四肢；软组织肿瘤；临床方案；治疗 软组织肉瘤 ( soft tissue sarcoma ，STS ) 是一组高度异质性不常见的肿瘤，目前 已经明确的 STS 亚型有 50 多种。成人最常见的 STS 依次为：多形性未分化肉瘤、脂肪 肉瘤、平滑肌肉瘤、滑膜 肉瘤及恶性神经鞘瘤 等。儿童最常见的 STS 是横纹肌肉瘤。对于成人 STS 并没有可以被广泛接受的治疗规范。一些预后因素已经 明确，包括肿瘤的病理分级、大小、部位及是否发生远处转移等。对于