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目的:分析头颈部恶性纤维组织细胞瘤(MFH)的临床特征和治疗方法。方法:回顾性分析28例头颈部MFH患者的临床资料,其中上颌骨9例,鼻腔3例,喉部5例,腮腺3例,颞骨3例,甲状腺1例,头颈软组织4例,均经免疫组织化学检测确诊。单纯手术切除4例,手术加放疗23例,单纯放疗1例。结果:5例1年后失访,按死亡计算,余均随访3年以上,1、3年生存率分别为96.4%(27/28)和57.1%(16/28);随访满5年23例,5年生存率为26.1%(6/23)。3年内复发率为60.7%(17/28),复发次数1～7次,平均复发时间为5.6个月,复发者1例采用放疗,12例采用非定型手术扩大切除。结论:头颈部MFH的确诊有赖于免疫组织化学技术,早期诊断、广泛手术切除、综合治疗能减少复发,提高生存率;复发者可采用非定型手术扩大切除以延长生命。
Objective: To analyze the clinical characteristics and treatment of head and neck malignant fibrous histiocytoma (MFH). Methods: The clinical data of 28 patients with head and neck MFH were retrospectively analyzed. Among them, 9 cases of maxillary bone, 3 cases of nasal cavity, 5 cases of larynx, 3 cases of parotid gland, 3 cases of temporal bone, 1 case of thyroid gland, 4 cases of soft tissue of head and neck Immunohistochemical detection confirmed. Surgical resection in 4 cases, surgery and radiotherapy in 23 cases, radiotherapy alone in 1 case. Results: Five patients were lost to follow-up one year later. All patients were followed up for more than 3 years. The 1-year and 3-year survival rates were 96.4% (27/28) and 57.1% (16/28), respectively. For example, the 5-year survival rate was 26.1% (6/23). The recurrence rate was 60.7% (17/28) in 3 years, and the recurrence frequency was 1 ~ 7 times. The average recurrence time was 5.6 months. One case of recurrence was treated by radiotherapy and the other 12 cases were treated by non-definite operation. Conclusion: The diagnosis of head and neck MFH relies on immunohistochemical techniques, early diagnosis, extensive surgical resection, comprehensive treatment can reduce recurrence and improve survival; recurrence may be expanded by non-stereotyped surgery to prolong life.