恶性间皮瘤29例分析

Malignant Mesothelioma. An Analysis of 29 Cases

本文回顾加拿大金斯顿总医院从1950～1987年经组织活检或尸检证实的恶性间皮瘤死亡病例29人,发现该病逐年增长,男与女之比为3:1,胸膜间皮瘤与腹膜间皮瘤之比亦为3:1,近半数患者年龄为50～59岁。胸膜间皮瘤的初始症状为气短、胸痛、咳嗽和体重减轻,胸片表现为胸腔积液、块影和胸膜增厚,原发灶约2/3在右侧。腹膜间皮瘤主要表现为腹块、腹痛及腹水,预后较胸膜间皮瘤更差。手术组预后略好,其他各治疗组与未治组的存活时间无显著性差异。分析各组患者确诊时的一般状况、接受治疗者所承担的风险、痛苦及花费,建议今后对已确诊的恶性间皮瘤病人,特别是Ⅱ期以上患者,在未有更有效疗法前,均可停止治疗,任其安乐死亡。

Twenty-nine cases of malignant mesothelioma, which were diagnosed histologi-cally by biopsy or autopsy from 1950 to 1957 in Kingston General Hospital, Canada were reviewed. The results showed that cases of malignant mesothelioma have been increasing year after year. The ratio of male to female was three to one; pleural and peritoneal involvements were of the same ratio. Most patients in this study aged 50-59 years. The initial symptoms of the patients were short breath, chest pain, cough and loss of weight. Their chest X-ray films manifested as pleural effusion, mass shadow, and pleural thickening. The primary site occurred on the right in about 2/3 of cases. The first manifestations in patients with peritoneal mesothelioma were abdominal mass, abdominal pain and ascites. The outcome of patients with malignant peritoneal mesothelioma was even more grave than pleural mesothelioma. Until definitively effective therapeutic measure is available, the authors, recommend supportive therapy only, once the disease goes beyond the state of Stage II.