腹膜浆液性乳头状腺癌的临床分析

目的探讨腹膜浆液性乳头状腺癌(腹膜浆乳癌)的临床特点及治疗。方法对1984年至2002年收治的14例腹膜浆乳癌和50例卵巢浆液性乳头状腺癌(卵巢浆乳癌)患者的临床表现、治疗效果及生存率进行回顾性对比分析。结果腹膜浆乳癌患者的平均年龄为62 7岁,卵巢浆乳癌患者的平均年龄为53 6岁,两者比较,差异有统计学意义(P<0 01)。腹膜浆乳癌患者有腹水12例(86%, 12 /14),有盆腹腔包块10例(71%, 10 /14);血清CA125平均水平为2289kU/L。卵巢浆乳癌患者有腹水40例(80%, 40 /50),有盆腹腔包块45例( 90%, 45 /50 );术前血清CA125平均水平为1741kU/L。两者分别比较,差异均无统计学意义(P>0 05 )。腹膜浆乳癌患者中12例行肿瘤细胞减灭术,术后均行化疗,对化疗耐药者10例(83%, 10 /12);另2例于手术前死亡。卵巢浆乳癌50例患者均行肿瘤细胞减灭术,术后均行化疗,对化疗耐药者19例(38%, 19 /50)。两者各项比较,差异均有统计学意义(P<0 05)。腹膜浆乳癌患者1、2、3年的生存率分别为72%、10%、0;卵巢浆乳癌患者分别为95%、79%、62%。两者分别比较,差异均有统计学意义(P<0 05)。结论腹膜浆乳癌患者较卵巢浆乳癌患者的发病年龄高,化疗效果及预后差。

Comparison of clinical characteristics of extraovarian peritoneal serous papillary carcinoma with papillary serous ovarian carcinoma

Objective To study the differences of clinical characteristics between patients with extraovarian peritoneal serous papillary carcinoma(EPSPC) and those with papillary serous ovarian carcinoma(PSOC). Methods Fourteen patients with EPSPC and 50 patients with PSOC who were admitted to Peking Union Medical College Hospital from 1984 to 2002 were retrospectively analyzed,and their clinical features,chemosensitivities and survival rate were compared. Results Patients with EPSPC were significantly older than those with PSOC (mean age 62.7 years versus 53.6 years, P<0.01). The chemo-resistant rate (83%) in EPSPC was significantly higher than that(38%) of the PSOC(P<0.05). The 1-, 2-, and 3-year survival rates (72%,10%,0%) in the EPSPC were significantly lower than those (95%,79%,62%) of the PSOC(P<0.05). Conclusion EPSPC are likely to occur in older women,have higher chemo-resistance and poorer prognosis compared with PSOC.