隆突性皮肤纤维肉瘤多学科诊治实施规范——上海交通大学医学院附属第九人民医院专家共识（2020年版）

doi:10.3969/j.issn.1674-8115.2021.12.018

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (12): 1669-1675.doi: 10.3969/j.issn.1674-8115.2021.12.018

• 论著 · 循证医学 • 上一篇

隆突性皮肤纤维肉瘤多学科诊治实施规范——上海交通大学医学院附属第九人民医院专家共识（2020年版）

^1.上海交通大学医学院附属第九人民医院皮肤科，上海 200011
^2.上海交通大学医学院附属第九人民医院整复外科，上海 200011
^3.上海交通大学医学院附属第九人民医院病理科，上海 200011
^4.上海交通大学医学院附属第九人民医院超声科，上海 200011

收稿日期:2021-07-12 出版日期:2021-12-28 发布日期:2022-01-28
通讯作者: 饶娅敏,徐慧
作者简介:第一联系人：陈骏（1981—），男，副主任医师，博士；电子信箱：chenjun125125@126.com
孙笛。（1980—），男，主治医师，博士；电子信箱：sundi1980hn@sina.com。为共同第一作者。
基金资助:
上海交通大学医学院附属第九人民医院临床研究型MDT项目(201901)

Practice for multidisciplinary diagnosis and treatment of dermatofibrosarcoma protuberans: expert consensus of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (2020 edition)

^1.Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
^2.Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
^3.Department of Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
^4.Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Received:2021-07-12 Online:2021-12-28 Published:2022-01-28
Contact: Ya-min RAO,Hui XU
Supported by:
Clinical Research Project of Multi-Disciplinary Team, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(201901)

摘要/Abstract

摘要：

隆突性皮肤纤维肉瘤是一种发生于皮肤及皮下组织的低度恶性软组织肉瘤。极高的误诊率常常延误了最佳的治疗时机，而错误的治疗方式导致了极高的手术复发率。传统扩大切除手术需要在肿瘤周边扩大3~5 cm，巨大的组织缺损增加了手术的难度，患者也难以接受。在上海交通大学医学院附属第九人民医院多学科诊治学组的支持下，皮肤梭形细胞肿瘤多学科精准诊疗团队开展了规范化隆突性皮肤纤维肉瘤综合诊治的推广应用，采用改良Mohs显微描记手术的方法，切净肿瘤的同时，保留尽可能多的正常组织，并由此形成了《隆突性皮肤纤维肉瘤多学科诊治实施规范——上海交通大学医学院附属第九人民医院专家共识》。

关键词: 隆突性皮肤纤维肉瘤, 多学科协作, 专家共识, 局部扩大切除, Mohs显微描记手术

Abstract:

Dermatofibrosarcoma protuberans (DFSP) is a low- to intermediate-grade malignant soft tissue sarcoma occurring in the skin and subcutaneous tissues. The high misdiagnosis rate often delays the best treatment opportunity, and the wrong treatment method leads to the high recurrence rate of surgery. Traditional extended resection requires 3?5 cm expansion around the tumor, and the huge tissue defect increases the difficulty of surgery, which is also hard to be accepted. In Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, under the support of the multi-disciplinary treatment group, cutaneous spindle cell neoplasms multi-disciplinary team of accurate diagnosis and treatment normatively conducted treatment of DFSP comprehensive diagnosis and treatment. Modified Mohs micrographic surgery was used to remove the tumor while preserving as much normal tissue as possible. Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine expert consensus of diagnosis and treatment of specification of DFSP multidisciplinary specification was formed.

Key words: dermatofibrosarcoma protuberans (DFSP), multi-disciplinary team (MDT), expert consensus, wide local excision (WLE), Mohs micrographic surgery (MMS)

中图分类号:

R751

. 隆突性皮肤纤维肉瘤多学科诊治实施规范——上海交通大学医学院附属第九人民医院专家共识（2020年版）[J]. 上海交通大学学报(医学版), 2021, 41(12): 1669-1675.

图/表 2

参考文献 24

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Stage	Standard
Stage Ⅰ	Local non-elevated lesions， including atrophy， sclerosing plaques， tiny nodules
Stage Ⅱ	Locally elevated primary lesions
Stage ⅡA	Tumor does not invade the fascia
Stage ⅡB	Tumor invades fascia or continues deep invasion
Stage Ⅲ	Lymph node metastasis occurs
Stage Ⅳ	Distant metastasis occurs

Stage	Standard
Stage Ⅰ	Local non-elevated lesions， including atrophy， sclerosing plaques， tiny nodules
Stage Ⅱ	Locally elevated primary lesions
Stage ⅡA	Tumor does not invade the fascia
Stage ⅡB	Tumor invades fascia or continues deep invasion
Stage Ⅲ	Lymph node metastasis occurs
Stage Ⅳ	Distant metastasis occurs

隆突性皮肤纤维肉瘤多学科诊治实施规范——上海交通大学医学院附属第九人民医院专家共识（2020年版）

Practice for multidisciplinary diagnosis and treatment of dermatofibrosarcoma protuberans: expert consensus of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (2020 edition)

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