恶性腹膜间皮瘤临床分析

Clinical Analysis of Malignant Peritoneal Mesothelioma

目的:探讨恶性腹膜间皮瘤(malignant peritoneal mesothelioma, MPM)的临床病理特点、诊断、治疗及预后。方法:收集青岛大学附属医院2015年至2023年于我院治疗的11例MPM患者临床资料,进行回顾性研究。结果:11例MPM患者,发病年龄为30~81岁,其中1例患者存在石棉暴露史。临床表现主要为腹胀及腹痛。初次治疗时4例患者CA125水平升高,余7例患者CA125正常,其PCI评分为3~29分。所有患者均行手术治疗,并据患者病情术后选择不同的辅助治疗,9例接受化疗,1例观察,失访1例。本研究患者总随访时间为4~53个月,存活4人。结论:MPM临床症状及影像学缺乏特异性,其诊断需依赖病理及免疫组织化学结果,确诊后治疗方案首选肿瘤细胞减灭术(cytoreductive surgery, CRS)联合腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy, HIPEC),术后以培美曲塞联合顺铂为一线化疗方案,MPM预后差,组织学亚型及腹膜癌指数评分(peritoneal cancer index, PCI)与其预后密切相关。

Objective: To discuss the clinical characteristics, pathological characteristics, diagnosis, treatment and prognosis of malignant peritoneal mesothelioma. Methods: The clinical data of 11 patients with MPM who were treated in the Affiliated Hospital of Qingdao University from 2015 to 2023 were col-lected for retrospective study. Results: Eleven patients with MPM were diagnosed at the onset of 30-81 years and one patient had a history of asbestos exposure. The clinical manifestations were mainly abdominal distension and abdominal pain. During the initial treatment, 4 patients had ele-vated CA125 levels, and the remaining 7 patients had normal CA125, and their PCI score was 3~29. All patients underwent surgery and chose different adjuvant therapy according to their condition, 9 received chemotherapy, 1 underwent observation and 1 was lost to follow-up. The total follow-up time of patients was 4~53 months in this study, with 4 people alive. Conclusion: Because of the lack of specificity of the clinical symptoms and imaging findings of MPM, Its diagnosis depends on patho-logical and immunohistochemical results. Treatment options are preferred cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy after diagnosis. The first-line chemo-therapy is pemetrexed and cisplatin. MPM has a poor prognosis, Histological subtype and the index score of peritoneal carcinoma is closely related to its prognosis.