9例卵巢外腹膜浆液性乳头状腺癌的诊断和治疗临床探讨  

Clinical Study on Diagnosis and Treatment for Nine Cases of Extraovarian Peritoneal Serous Papillary Carcinoma

作　　者：何芳[1] 汤惠茹[1] 王丽平[1] 刘志红[1] 黄凤英[2] 

机构地区：[1]北京大学深圳医院妇产科,深圳518036 [2]中南大学湘雅医学院第二附属医院妇产科,长沙410011

出　　处：《中国现代医生》2008年第33期26-27,F0003,共3页China Modern Doctor

摘　　要：目的探讨卵巢外腹膜浆液性乳头状腺癌的诊断和治疗。方法9例患者均行剖腹探查术和配合化疗。根据病变情况选择不同的手术方式,即在切除全子宫、双侧附件、大网膜后,对直径大于1.0cm的肿瘤结节予以剔除,对于不能切尽的小结节则采用电凝烧灼;2例同时行盆腔淋巴结清扫术,1例行部分左半结肠切除术。关腹前将顺铂注入腹腔。术后采用PC、PAC方案化疗8个疗程。结果病理检查示5例细胞呈中等分化,4例呈低分化。子宫内膜均未见肿瘤浸润;6例卵巢结构如常,3例卵巢上皮浅表有肿瘤组织浸润。l例术后刚满1个月死亡;1例患者对化疗不敏感,腹水不能控制,于术后2个月死亡;2例分别于术后6个月和8个月肿瘤复发并导致肠梗阻,再次减瘤术后3个月和5个月死亡;2例于术后10个月和14个月复发,拒绝治疗并失访;2例失访;仅l例Ⅲb期患者至今无瘤生存4年。结论手术是治疗EPSPC的首选方式,且有助于EPSPC的确诊。EPSPC手术治疗的原则与卵巢癌相同,均为肿瘤细胞减灭术,术后辅以规范的化疗,有助于延长存活期,降低复发率。Objective To study and evaluate diagnosis and treatment for extraovarian peritoneal serous papillary carcinoma. Methods Because of abdominal distention, 9 patients with ascites were diagnosed as ad They were all under chemotherapy after exploratory laparotomy. There were ascites in all 9 patients,dispersed in tumour nodules; 6 patients＇ ovaries were normal size and smooth surface;3 patients＇ovaries were bigger than normal,had coarse small nodules in surface; big omental tumour was distracted in all patients;5 patients appeared diffuse infiltration of small nodular,tumour infiltration of 4 patients formed big omental laminar structure. According lesions to choose different surgical methods,after removed hole uterus,bilateral adnexa,and big omental,eliminated tumour nodules which diameter was more than 1.0cm. Used electrocoagulation to clear up the small nodules which can＇t clear up in elimination. 2 patients were under pelvic lymphadenectomy,used partial left hemi-colectomy in one patient. Affused cisplatin into abdomen before it sew up. Chemotherapy by PCor PAC for 8 periods of treatment after surgery. Results 5 patients were middle differentiation and 4 patients were low differentiation in pathological test. All patients didn＇t appear infiltration of tumour in uterus endom,6 patients＇ ovaries were normal structure, one patient appeared ovarian epicutiula tumour organic infiltration. One patient was dead in one month after surgery. One patient was in-sensitive to chemotherapy, his ascites was out of control, was dead in two months after surgery. 2 patients＇ tumour relapsed respectively in 6 months and 8 months after surgery, and it caused ileus,but they were dead respectively in 3 months and 5 months after removing again surgery：2 patients＇ relapsed respectively in 10 months and 14 months after surgery,they refused treatment and lost vistation. 2 patients lost visitation：only one Ⅲ b patient lived for four years without tumour. Conclusion Surgery is preferred for treating EPSPC,and it is usefu

关 键 词：卵巢外腹膜浆液性乳头状腺癌 手术治疗 术后化疗 

分 类 号：R737.31[医药卫生—肿瘤]