目的:诊断怀疑非典型脂肪瘤(ALT)是困难的。这项研究的目的是深入研究该主题中最有争议的诊断方面。
方法:观察性,纵向,2006年至2016年一系列96例深度脂肪组织(75例脂肪瘤和21例TLA)的回顾性研究:人口统计学,临床,影像学和病理变量进行了分析和比较,以及与患者治疗和肿瘤预后相关的其他变量。对收集的变量进行描述性分析,以进行统计学研究。为了评估恶性肿瘤的潜在预测变量,进行了多变量逻辑回归分析,包括在单变量分析中具有统计学意义的那些。
结果:诊断时年龄较大,在ALTs中,下肢位置和较大尺寸明显更常见.两组MRI检查结果无统计学差异。在多变量分析中,同样的临床变量被证实为恶性肿瘤的预测因子.在ROC曲线中,最佳切点134.0mm被用作恶性肿瘤的预测因子.
结论:高龄,在鉴别诊断深层脂肪瘤和非典型脂肪瘤中,下肢的位置和较大的体积是恶性肿瘤的危险因素。在我们的系列中,MRI上没有放射学变量作为恶性肿瘤的预测因子。
OBJECTIVE: The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject.
METHODS: Observational, longitudinal and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis.
RESULTS: Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0mm was used as a predictor of malignancy.
CONCLUSIONS: Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.