摘要
背景与目的:卵巢外腹膜浆液性乳头状癌(extraovarian peritoneal serous papillary carcinoma, EPSPC)是原发于腹膜间皮,有时可累及卵巢表面,呈多灶性发生的恶性肿瘤,发病率低,近年来逐渐引起人们的重视,目前暂无标准的治疗方案。本文分析11例EPSPC,初步探讨其临床特征、治疗及预后。方法:回顾性分析11例EPSPC临床特征,采用肿瘤细胞减灭术及术后辅助化疗进行综合治疗,最后采用RECIST评价近期疗效,进展时间(TTP)及总生存率评价远期疗效。结果:EPSPC患者临床表现均为腹痛,进行性加重腹胀、腹水,但仅有18.2%可体检查出腹部包块,腹水阳性率为100%。腹部B超、MRI扫描发现腹部包块的阳性率分别为45.5%、100%,血浆、腹水CA125升高>300U/ml(正常<35U/ml)的比率分别为72.7%(8/11)、81.8%(9/11)。EPSPC患者肿瘤细胞减灭术的成功率为45.5%。化疗完全缓解1例(11.1%,1/9),部分缓解3例(33.3%,3/9),稳定2例(22.2%,2/9),进展3例(33.3%,3/9),化疗有效率为4例(44.4%,4/9)。TTP为5~14个月,中位TTP为8.6个月,1、2、3年生存率分别为72.7%(8/11)、18.2%(2/11)和0%(0/11),中位生存期14.6个月。结论:EPSPC临床症状无特异,腹水癌细胞检查、腹部MRI以及血浆与腹水CA125的表达水平对诊断EPSPC最具有临床意义。EPSPC肿瘤细胞减灭术的成功率低,对化疗抗拒,预后极差。
Background and purpose: Extraovarian peritoneal serous papillary carcinoma(EPSPC) originats from peritoneum with rare incidence, sometimes may affect the surface of ovary and have multi-focal lesions, whose standard therapy have not been established. In this study, we preliminarily reviewed the clinical characteristics, treatment and prognosis of EPSPC in 11 cases. Methods: The clinical characteristics of 11 cases with EPSPC were first retrospectively analyzed. All the patients underwent cytoreduction surgery followed by chemotherapy. Finally, short-term and long-term efficacy, time to progression (TTP) and overall survival were evaluated by RECIST, respectively. Results: Abdominal pain, distention and ascites were the most common presenting symptoms, but tumors could be palpable in only 18.2% of the patients. The positive rate of ascites, abdomen B ultrasound,MRI scan and ascending CA125 level in the plasma and ascites was 100%,45.5%, 100%,72.7%,81.2%,respectively. The successful rate of cytoreduetion surgery was 45.5% for the EPSPC. After chemotherapy, the cases of complete remission, partial remission, stable disease and progression disease were 1(11.1%,1/9),3(33.3%,3/9),2(22.2%,2/9) and 3(33.3%,4/9), respectively. TTP was 5-14 months for all the patients and the median TTP was 8.6 months. The 1,2,3-year overall survival was 72.7%,18.2%,0%, respectively and the median overall survival was 14.6 months. Conclusions: Ascite, abdomen MRI scan and CA125 level are the most meaningful factor to diagnose EPSPC. EPSPC is a carcinoma of poor prognostic with non-specific clinical characteristics, low successful rate of cytoreduction surgery and is chemotherapy-resistent.
出处
《中国癌症杂志》
CAS
CSCD
2008年第7期545-547,共3页
China Oncology
关键词
卵巢外腹膜浆液性乳头状癌
临床特征
治疗
预后
extraovarian peritoneal serous papillary carcinoma
clinical characteristics
treatment
prognosis