恶性胸膜间皮瘤病例报告和分析

目的分析恶性胸膜间皮瘤的临床病例特点，以探讨早期诊断、治疗的方法。方法1998年～2008年收入院11例恶性胸膜间皮瘤患者，男7例，女4例，年龄（63．7±12．6）（41～79）岁，均经病理资料确诊；对其临床资料进行回顾性分析。结果11例患者中10例（90．91％）有呼吸困难和胸痛的症状。11例（100％）患者均有胸腔积液。5例（45．45％）CT表现为胸膜肥厚，3例（27．27％）表现为胸膜结节影。对其中7例患者的胸腔积液的分析表明，7例胸水CEA水平均在正常范围，其中2例行CYFRA21—1检查，CYFRA21—1均升高；7例患者血清学肿瘤标记物CEA检查均在正常范围，其中6例（85．71％）行血清学CYFRA21—1检查提示均升高。结论恶性胸膜间皮瘤最常见的症状是呼吸困难和胸痛。CT对于恶性胸膜间皮瘤的诊断价值高于胸部X线：胸腔积液肿瘤标记物CYFRA21—1水平高而CEA水平正常对于恶性胸膜间皮瘤的诊断具有提示意义．

Clinical features of malignant pleural mesothelioma: analysis of 11 cases

Objective To investigate the diagnosis and treatment of malignant pleural mesothelioma （MPM）. Methods The clinical data of 11 cases of MPM hospitalized from Jan.l.1998 to Jan.l.2008, 7 males and 4 females, aged （63.7±12.6） （41N79）, were analyzed retrospectively. Results Ten of the 11 patients had symptoms of dyspnea and chest wall pain （90.91%）. All 11 patients （100%） had pleural effusion. CT showed pleural thickening in 5 patients （45.45%）and pleural nodules in 3 patients （27.27%）.Analysis of pleural effusion in 7 cases showed that none of them had an elevated level of CEA, and 2 cases underwent CYFRA 21-1 level analysis with the result of elevated CYFRA 21-1 level Seven patients underwent carcinoembryonic antigen （CEA） analysis and all showed normal CEA levels Serum CYFRA 21-1 analysis in these 7 cases showed that 6 of them （85.71%） had elevated serum CYFRA 21-1 levels. Treatment included surgery and chemotherapy. The mean survival time was 13.9 months. Conclusion The most common symptoms of MPM are dyspnea and chest wall pain. CT is more valuable in the diagnosis of MPM than chest X-ray. An elevated level of CYFRA 21-1 with a low CEA level in pleural effusion is highly suggestive of MPM.