恶性胸膜间皮瘤的诊断与治疗

目的探讨恶性胸膜间皮瘤的诊断和治疗方法。方法回顾分析我院1999.03—2006.03经病理确诊的18例恶性胸膜间质瘤患者的临床资料。结果本组18例中，男11例，女7例，男女之比为1．6：1。年龄以35。65岁多见。主要症状：胸痛15例，呼吸困难12例，咳嗽9例。15例胸部X线表现为大量胸腔积液，其中11例伴胸膜广泛增厚；13例胸腔穿刺抽液检查，其中8例血性胸液，5例为黄色胸液。11例外科手术活检确诊，7例胸腔穿刺取得病理。15例外科手术治疗，其中行根治术9例，术后2年生存率44．4％（4／9），5年生存率22．2％（2／9）；行姑息术6例，术后2年生存率16．7％（1／6），5年生存率为0。单纯化疗2例，2年生存率为0；未经治疗1例。1年内死亡。结论恶性胸膜间皮瘤以胸痛，呼吸困难，咳嗽为主要症状；以手术活检和穿刺活检为主要诊断方法；以手术为主要治疗方法，配合术后化疗效果更佳。

The Diagnosis and Treatment of Malignant Pleural Mesothelioma

Objective To investigate the diagnosis and treatment of malignant pleural mesothelioma(MPM).Methods The clinical data of 18 cases with MPM covering a period frome 1999 to 2006 were analyzed retrospectively.Results Of all the 18 cases,11 cases are male,7 cases are female,male:female=1.6:1,patients age.The main symptoms were chest pain(15/18),dyspnea(12/18),cough(9/18);Through the radiologic findings,we could find 15 cases showing plenty of pleural effusion and with pleural thickening among 10 of them;In the 13 analysis of pleural effusion cases,8 cases were blood-red,and 5 were yellow;11 cases were diagnosed through the operation examination,7 cases were diagnosed via the needle biopsy of pleura;Among all the cases,15 patients were treated by surgical treatment,9 cases chose radical resection which the overall survival rates were 44.4% at 2 years and 22.2% at 5 years;6 cases chose palliative pleurectomy which the overall survival rates were 16.7% at 2 years and 0% at 5 years;2 cases only chose chemotherapy which the overall survival rates were 0% at 2 yeras;1 case died within one year without any treatment.Conclusion Chest pain,dyspnea,cough are always showed on malignant pleural mesothelioma cases,the operation examination and needle biopsy of pleura are most important diagnosis measures;Surgical treatment is appropriate treatment for MPM,and the result of making the chemotherapy after surgical treatment is better.