恶性腹膜间皮瘤41例诊治体会

目的 探讨恶性腹膜问皮瘤的临床诊断与治疗方法。方法 对41例外科治疗并经病理证实的恶性腹膜问皮瘤临床资料进行回顾性分析。结果 41例恶性腹膜间皮瘤中,主要临床表现为持续性腹痛者38例(92．7％),腹泻35例(85．4％)。病理类型为上皮样型21例,梭形细胞型11例,混合型9例。21例行CT检查,13例行腹腔镜检查。手术切除率为70．7％,术后行腹腔局部灌注化疗12例(29．3％),全身化疗23例(56．1％),免疫治疗3例(7．3％);全组2年生存率为36．6％。结论 影像学检查是恶性腹膜间皮瘤的主要诊断方法,但肿瘤的确诊须依据病理诊断;恶性腹膜间皮瘤应采用以手术为主的综合治疗方法。

Diagnosis and treatment of 41 patients with malignant peritoneal mesothelioma

Objective To study the methods of diagnosis and treatment of malignant peritoneal mesothelioma. Methods The clinical data of 41 patients with malignant peritoneal mesothelioma pathologically confirmed were retrospectively analyzed. Results Of these 41 patients, abdominal pain and diarrhea were found in 38 and 35. The histopathologic types were: epitheloid, fusiform and mixed in 21, 11 and 9 cases. CT was performed in 21 and laparoscopic exploration in 13. The overall surgical resection rate was 70.7%. After operation, local abdominal cavity chemotherapeutic instillation was given in 12, systemic chemotherapy in 23 and immunotherapy in 3. The two year survival rate was 36.6%. Conclusion For malignant peritoneal mesothelioma, the final diagnosis depends on histological examination and the treatment should be surgical core combined methods.