腹膜假黏液瘤的临床特征及预后因素分析  

Clinical characteristics and prognostic analysis of pseudomyxoma peritonei

作　　者：魏振军[1] 李虹义[1] 梁浩[2] 罗继征[1] 

机构地区：[1]北京军区总医院干二科,100700 [2]解放军总医院消化科,北京100853

出　　处：《武警医学》2013年第9期748-750,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨腹膜假黏液瘤的临床特征及影响预后的因素。方法回顾性分析23例腹膜假黏液瘤的临床及随访资料,采用Kaplan-Meier法进行生存分析,Log-rank检验比较各样本生存期。结果主要症状为进行性腹胀、腹部包块、腹痛等。17例行腹腔减瘤术,3例行肿瘤细胞减灭术,9例行术后腹腔灌注化疗。总体3年、5年、10年生存率分别为79.7%、54.7%、27.3%,中位生存时间120个月。生存因素分析表明阑尾黏液性肿瘤病理类型与预后相关(P=0.012)。结论腹膜假黏液瘤术前确诊困难,综合应用腹部影像学等检查有助于诊断,手术联合腹腔灌注化疗是主要治疗方法,原发阑尾黏液性肿瘤性质影响腹膜假黏液瘤预后。Objective To investigate the clinical features and prognostic factors of pseudomyxoma peritonei（PMP）. Methods The clinical characteristics and follow - up data of 23 patients with PMP admitted to the General Hospital of PLA in the past fourteen years were retrospectively analyzed. Survival analysis was evaluated through Kaplan - Meier and Log - rank tests. Results The mean age was 56.6 ± 12.8 （ range 36 - 75） （57% male, 43% female）. Abdominal distension, mass and pain were major symptoms. Ascites and mass were often found in the examination of abdominal imaging such as CT and ultrosonography. Of 23 patients, 17 underwent dehulking surgery and 3 had complete cytoreductive surgery. Intraperitoneal chemotherapies,were followed after surgery in 9 patients. Survival analysis（ Kaplan -Meier method） showed that the median survival time was 120.0 months and 3 - ,5 - ,10 -years survival rates were 79.7 % ,54.7 % ,27.3 % , respectively. Survival time of patients was closely correlated with primary appendiceal neoplasm. Conclusions Preoperative diagnosis of PMP is difficult, imagings including CT and ultrasonography are beneficial to the definite diagnosis. Pathological type of appendiceal mucinous neoplasm affects the survival of patients with PMP. Surgery combined with intraperitoneal chemotherapy is the standard treatment and can improve short -term outcome. Long- term survival is not achieved well.

关 键 词：腹膜假黏液瘤 预后 单因素分析 

分 类 号：R735.36[医药卫生—肿瘤] R735.5[医药卫生—临床医学]