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目的探讨腹膜浆液性乳头状腺癌(腹膜浆乳癌)的临床特点及治疗。方法对1984年至2002年收治的14例腹膜浆乳癌和50例卵巢浆液性乳头状腺癌(卵巢浆乳癌)患者的临床表现、治疗效果及生存率进行回顾性对比分析。结果腹膜浆乳癌患者的平均年龄为62 7岁,卵巢浆乳癌患者的平均年龄为53 6岁,两者比较,差异有统计学意义(P<0 01)。腹膜浆乳癌患者有腹水12例(86%, 12 /14),有盆腹腔包块10例(71%, 10 /14);血清CA125平均水平为2289kU/L。卵巢浆乳癌患者有腹水40例(80%, 40 /50),有盆腹腔包块45例( 90%, 45 /50 );术前血清CA125平均水平为1741kU/L。两者分别比较,差异均无统计学意义(P>0 05 )。腹膜浆乳癌患者中12例行肿瘤细胞减灭术,术后均行化疗,对化疗耐药者10例(83%, 10 /12);另2例于手术前死亡。卵巢浆乳癌50例患者均行肿瘤细胞减灭术,术后均行化疗,对化疗耐药者19例(38%, 19 /50)。两者各项比较,差异均有统计学意义(P<0 05)。腹膜浆乳癌患者1、2、3年的生存率分别为72%、10%、0;卵巢浆乳癌患者分别为95%、79%、62%。两者分别比较,差异均有统计学意义(P<0 05)。结论腹膜浆乳癌患者较卵巢浆乳癌患者的发病年龄高,化疗效果及预后差。
Objective To investigate the clinical features and treatment of peritoneal serous papillary adenocarcinoma (peritoneal carcinoma of the breast). Methods The clinical manifestations, therapeutic effects and survival rates of 14 patients with peritoneal and 50 patients with ovarian serous papillary adenocarcinoma (ovarian serous carcinoma) who were admitted from 1984 to 2002 were retrospectively analyzed. Results The average age of patients with peritoneal breast cancer was 62.7 years. The average age of patients with ovarian cystadenocarcinoma was 53.6 years old. There was significant difference between the two groups (P <0.01). Peritoneal patients with ascites had ascites in 12 cases (86%, 12/14), pelvic mass in 10 cases (71%, 10/14), and mean serum CA125 level was 2289 kU / L. There were 40 patients (80%, 40/50) with ascites in patients with ovarian cystadenocarcinoma, 45 cases (90%, 45/50) with pelvic and abdominal mass, and 1741 kU / L in preoperative serum CA125. There was no significant difference between the two groups (P> 0.05). Twelve patients with peritoneal breast cancer were treated with cytoreductive surgery and chemotherapy was performed after surgery. Ten patients were resistant to chemotherapy (83%, 10/12), and the other two patients died before surgery. Fifty patients with ovarian cystadenocarcinoma underwent cytoreductive surgery. Chemotherapy was performed after surgery, and 19 were resistant to chemotherapy (38%, 19/50). The comparison between the two, the difference was statistically significant (P <0 05). The survival rates of patients with peritoneal breast cancer at 1, 2, and 3 years were 72%, 10%, 0, respectively; 95%, 79%, 62% of patients with ESCC, respectively. The difference between the two was statistically significant (P <0 05). Conclusion The patients with peritoneal breast cancer have higher age of onset than those with ovarian cancer, and the chemotherapy effect and prognosis are poor.