复发性腹膜假黏液瘤病理分析

目的 探讨复发性腹膜假黏液瘤（PMP）病理级别的变化，分析复发前病理级别同P53表达的相关性。方法 回顾分析2008年1月~2016年4月74例复发手术并行病理检查≥2次腹膜假黏液瘤临床病理资料，按照2010年WHO标准，分别分为低级别腹膜假黏液瘤及高级别腹膜假黏液瘤，观察复发前、后级别变化情况，并分析复发前次手术病理级别同P53表达的关系。结果 74例复发病例中，复发前后级别不变，提高、降低的病例分别为65例，6例，3例。复发前低级别、高级别病变P53阳性率分别为9.58%±15.02%及47.46%±34.18%，相关系数为0.521（P=0.000）；Logistic分析显示P53变量偏回归系数为0.054，差异均具有统计学意义（P=0.000）。高级别腹膜假黏液瘤P53阳性率高，而低级别PMPP53阳性率低。结论 腹膜假黏液瘤自然病程长，复发率高，复发前病理级别可作为复发后选择术中治疗方案的参考；P53指标可作为评价级别的指标之一。

Pathological Analysis of Recurrent Pseudomyxoma Peritonei

Objective To investigate the grade of pathological changes in recurrent pseudomyxoma peritonei,And the correlation between the grade and the expression of P53. Methods According to the WHO standards of 2010, pseudomyxoma peritonei was classified as low grade and high grade.Retrospective analysis of 74 cases of recurrent pseudomyxoma peritonei in 2008 January to 2016 April was performed. And we observed the grade changes,analyzed the relationship between the previous pathology grade with the expression of P53. Results In 74 recurrent cases, the grade was unchanged in 65 cases,and 6 cases were improved,while 3 cases were decreased. In low-grade and high-grade lesions,P53 positive rate respectively were:9.58%±15.02% and 47.46%±34.18%, the correlation coefficient was 0.521(P=0.000). Logistic analysis showed that the expression of P53 has positive correlation with the grade. Conclusion The recurrence rate of pseudomyxoma peritonei is high.The grade of PMP in pre-recurrence can be referenced in post recurrence,to provide evidence for clinical treament.