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目的总结腹膜恶性间皮瘤(PMM)的临床表现及其在腹腔镜下的特征,以达到早期诊断腹膜恶性间皮瘤的目的。方法回顾性分析12例腹膜恶性间皮瘤的临床资料,总结PMM的临床表现、肿瘤标记物、腹水检查、腹腔镜检查及病理检查的特点。结果12例患者均为渗出性腹水,83.3%患者腹水间皮细胞含量≥5%。在腹腔镜下,PMM表现为白色小结节,结节大小以0.3~0.5 cm为主,主要分布于侧腹壁及大网膜;腹水呈黄色浑浊或淡血性腹水。结论腹水间皮细胞含量结合腹水腺苷脱氨酶(ADA)、腹水肿瘤标记物检查是术前鉴别恶性间皮瘤和结核性腹膜炎、腹腔转移性腺癌的最好指标。腹腔镜检查是早期诊断腹膜恶性间皮瘤的最好手段。
Objective To summarize the clinical manifestations of peritoneal malignant mesothelioma (PMM) and its characteristics in laparoscopy in order to achieve the purpose of early diagnosis of peritoneal malignant mesothelioma. Methods The clinical data of 12 cases of peritoneal malignant mesothelioma were retrospectively analyzed. The clinical manifestations, tumor markers, ascites, laparoscopy and pathological features of PMM were summarized. Results All the 12 patients were exudative ascites, 83.3% of patients with ascites mesothelial cell content ≥ 5%. In laparoscopy, PMM showed small white nodules, nodular size of 0.3 ~ 0.5 cm, mainly in the lateral abdominal wall and omental; ascites was yellow cloudy or pale bloody ascites. Conclusion Ascites mesothelial cells combined with ascitic adenosine deaminase (ADA), ascites tumor markers examination is the best indicator of malignant mesothelioma and tuberculous peritonitis, peritoneal metastatic adenocarcinoma. Laparoscopy is the best early diagnosis of peritoneal mesothelioma.