腹膜假黏液瘤的临床病理学特征分析  

Clinical and pathological features of pesudomyxoma peritonei

作　　者：郭爱桃[1] 李岩密[2] 韦立新[1] 宋欣[1] 

机构地区：[1]解放军总医院病理科,北京100853 [2]解放军总医院超声诊断科,北京100853

出　　处：《军医进修学院学报》2012年第9期929-932,共4页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的评价腹膜假黏液瘤(pseudomyxoma peritonei,PMP)的临床病理学特征。方法收集我院收治的92例PMP的临床、病理及随访资料,将92例分为腹膜弥漫性黏液腺瘤病(disseminated peritoneal adenomucinosis,DPAM)、腹膜黏液腺癌病(peritoneal mucinous carcinomatosis,PMCA)以及交界性腹膜弥漫性黏液腺癌病(PMCA with intermediate or discordant features,PMCA-I/D)三组,采用Kaplan meier法计算整体生存率,并分析预后相关因素。结果 92例中3、5和10年的整体生存率分别为74.0%、67.4%和49.1%,22例死亡,中位生存期124.0月;平均年龄51.9岁(22-76岁)。DPAM组49例,中位生存期312.9月,8例(16.3%)死亡,3、5及10年生存率为97.0%、80.0%及67.0%。PMCA-I/D组26例,中位生存期84.0月,6例(23.1%)死亡,3年、5年及10年生存率分别为80.0%、67.0%及50.0%。PMCA组17例,中位生存期31.7月,其中8例(47.1%)死亡,3及5年生存率为65.0%及28.0%,最长随访时间为108个月。DPAM组预后最好,PMCA组预后最差,3组间生存率差异具有显著性(P=0.001)。年龄、阑尾肿瘤、实质脏器受累与患者生存期关系密切,<40岁者预后最差(P=0.001)。结论在病理诊断中应采用DPAM、PMCA和PMCA-I/D对PMP进行分类,废弃PMP这一模棱两可的名称;虽然大部分病例病理形态为良性或低度恶性,患者10年生存率仍较低;病理学分类、年龄、阑尾肿瘤及实质脏器累及为临床预后相关因素,<40岁、伴有阑尾黏液腺癌和实质脏器受累者预后更差。Objective To assess the clinical and pathological features of pseudomyxoma peritonei（PMP）. Methods Clinical, pathological and follow-up data about 92 PMP patients admitted to our hospital were retrospectively analyzed. The patients were divided into disseminated peritoneal adenomucinosis（DPAM） group（n=49）, peritoneal mucinous carcinomatosis（PMCA） group （n=17）, and PMCA with intermediate or discordant features（PMCA-I/D） group（n=26）. Their survival rate was calculated with the Kaplan-Meier method and related factors for their prognosis were analyzed. Results Twenty-two of the 92 PMP patients died at the mean age of 51.9 years（22-76 years） with a median survival time of 124.0 months and their 3-, 5-, and 10-year survival rate was 74.0%, 67.0% and 49.0%, respectively. Eight patients in DPAM group died with a median survival time of 312.9 months and their 3-, 5-, and 10-year survival rate was 97.0%, 80.0%, and 67.0%, respectively. Six patients in PMCA-I/D group died with a median survival time of 84.0 months and their 3-, 5-, and 10-year survival rate was 80.0%, 67.0%, and 50.0%, respectively. Eight patients in PMCA group died with a median survival time of 31.7 months and their 3- and 5-year survival rate was 65.0% and 28.0%, respectively. The longest follow-up time was 108 months with the best prognosis observed in DPAM group and the poorest prognosis observed in PMCA group（P=0.001）. The survival time of the patients, especially those with their age 〈40 years, was closely related with their age, appendiceal tumor and parenchymal organ involvement. Conclusion PMP should be used as DPAM, PMCA and PMCA-I/D in its pathological diagnosis. Although the pathological morphology of most PMP patients is benign or low malignant, their 10 -year survival rate is rather low. The prognosis of PMP patients, especially those with their age 〈40 years, is closely related with their age, appendiceal tumor and parenchymal organ involvement.

关 键 词：假黏液瘤 腹膜 病理学 临床 预后 

分 类 号：R446.83[医药卫生—诊断学]