目的: 探讨胸膜孤立性纤维瘤的临床特点、诊断、治疗及预后。方法: 回顾性研究内蒙古医科大学附
属医院2005－01～ 2015－12 治疗的45 例胸膜孤立性纤维瘤病人的临床表现、病理资料、手术方法及预后。结果:
45 例病人中，男性28 例，女性17 例，平均年龄为57．6岁; 所有病人均无石棉接触史; 术前CT 诊断率40%，误诊率
60%; 穿刺诊断率47%; 44 例行手术治疗，其中胸腔镜手术19 例( 43．2%) ，开胸手术25 例( 56．8%) ，均完整切除
肿瘤手术切除率100%。1 例不能耐受手术者随访观察病情平稳。术后免疫组化: CD34 阳性率95．5%、Vim 阳性
率82．2%、bcl－2 阳性率82．2%、所有病人随访观察，其中失访3 例，其余41 例手术病人1～ 9a 均未见复发。结论:
胸膜孤立性纤维瘤临床中罕见，术前误诊率高，手术是主要的治疗手段，诊断主要依靠病理检查。术后预后一般
较好。

Objective: To investigate the clinical features of solitary fibrous tumor of the pleura，diagnosis，
treatment and prognosis．Methods: A retrospective study of the clinical manifestations of Affiliated
Hospital of Inner Mongolia Medical University January 2005 to December 2015 treated 45 cases of
pleural solitary fibrous tumor patients，pathological data， surgical methods and prognosis．Result: Among
45 patients， 28males and 17 females，mean age 57．6years; all patients had no history of exposure to asbestos;
preoperative CT diagnosis rate of 40% misdiagnosis rate of 60%; invasive diagnostic rate of
47%; 44routine surgery，thoracic surgery in which 19 cases ( 43．2%) ，thoracic surgery 25 cases
( 56．8%) ，are the complete removal of the tumor resection rate was100%．One case we can not tolerate
surgery follow － up observation of stable disease． After immunohistochemistry: CD34 positive rate of
95．5%，Vim positive rate of 82．2%，bcl－2positive rate of 82．2%， follow－up study in which all patients
were lost to follow three cases，and the remaining 41 cases of surgical patients1 ～ 9 annual no recur-
rence．Conclusion: The diagnosis of pleural solitary fibroids in clinical rare，high rate of preoperative
misdiagnosis，diagnosis depends mainly on pathological examination．Surgery is the main treatment，postoperative
prognosis is generally better．

R734．3

 收稿日期: 2016－09－20; 修回日期: 2016－11－08
基金项目: 内蒙古医科大学青年基金项目( YKD 2014 QNCX031) ;
内蒙古医科大学附属医院一般项目( NYFY YB2014024)
作者简介: 王宇飞( 1983－) ，男，内蒙古医科大学附属医院胸外科主治医师，医学硕士。
通讯作者: 郭占林，教授，医学博士，硕士研究生导师，E－mail: nmggzl@ 163． com 内蒙古医科大学附属医院胸外科，
010050