恶性腹膜间皮瘤的诊断和治疗现状  

Recent advances in diagnosis and treatment of malignant peritoneal mesothelioma

作　　者：黄颖秋[1] 

机构地区：[1]中国医科大学第五临床学院,本溪钢铁(集团)总医院消化内科,辽宁省本溪市117000

出　　处：《世界华人消化杂志》2017年第26期2329-2340,共12页World Chinese Journal of Digestology

摘　　要：恶性腹膜间皮瘤(malignant peritoneal mesothelioma,MPM)是原发于腹膜间皮细胞的一种罕见恶性肿瘤,通常与接触石棉有关,预后不良,平均生存期6-12 mo,早期诊断和有效治疗十分困难.MPM大约占全部恶性间皮瘤的10%-15%.其主要症状为腹痛、腹胀、腹部包块、腹水、体质量减轻、发热和呕吐等.计算机断层扫描(computed tomography,CT)、磁共振成像、正电子发射计算机断层扫描/CT、血清肿瘤标志物、分子生物标志物、腹腔镜活检、组织病理学、细胞学、免疫组织化学以及电子显微镜技术已被用于MPM的诊断和随访.此外,本文还重点阐述了MPM的治疗进展,包括细胞减灭术(cytoreductive surgery,CRS)联合腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)、化学治疗、放射治疗、分子靶向治疗、pH敏感的紫杉醇膨胀性纳米粒子靶向治疗、免疫治疗等.目前,CRS/HIPEC仍是治疗晚期MPM患者的唯一有效方法.Malignant peritoneal mesothelioma （MPM） is a rare malignant neoplasm that arises from mesothelial cells that line the peritoneal cavity. It is typically associated with exposure to asbestos and has a poor prognosis （average survival time of 6 to 12 too）, presenting huge difficulties in early diagnosis and effective treatment. MPM represents approximately 10% to 15% of all malignant mesothelioma diagnoses. The most common symptoms in MPM patients include abdominal pain, abdominal distension, abdominal mass, ascites, weight loss, fever, and vomiting. Computed tomography （CT）, magnetic resonance imaging, positron emission tomography/CT, serum tumor markers, molecular biomarkers, laparoscopic biopsy, histopathology, cytology, immunohistochemistry, and electron microscopy are often used in diagnosis and follow-up. The therapies for MPM include cytoreductive surgery （CRS） combined with hypertherrnic intraperitoneal chemotherapy （HIPEC）, chemotherapy, radiotherapy, targeted molecular therapy, paclitaxeMoaded pH-responsive expansile nanoparticle targeted therapy, and immunotherapy. Currently, CRS/HIPEC remains the only optimal choice with acknowledged treatment efficiency for advanced MPM patients.

关 键 词：恶性腹膜间皮瘤 发病机制 诊断 治疗 细胞减灭术 腹腔热灌注化疗 

分 类 号：R735.5[医药卫生—肿瘤]