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目的 探讨腹膜假性粘液瘤的诊断和治疗。方法 总结 8例患者的诊治经验 ,并复习文献。结果 8例患者 ,主要临床表现为腹痛、腹胀、腹部包块和全身消耗 ,2例术前超声检查提示不均质腹水 ,4例查CEA者均升高。所有患者均经手术治疗 ,病理证实 7例来自阑尾粘液腺癌 ,1例来自降结肠粘液腺癌。手术包括切除原发病灶、网膜、或其它脏器及尽可能清除粘液性病变组织。患者均经手术治疗 ,术后辅助治疗包括化疗和放疗。术后随访率 10 0 % (8/ 8) ,5年存活率 5 0 % (4 / 8) ,10年存活率 13% (1/ 8)。结论 腹膜假性粘液瘤是一种少见病 ,术前诊断很困难。B超和CEA检查对诊断可能有帮助。由于其低度恶性、极少转移 ,经过反复侵袭性手术并辅以化疗和 /或放疗能明显提高生存率。
Objective To investigate the diagnosis and treatment of peritoneal pseudomyxoma. Methods The diagnosis and treatment experience of 8 patients was summarized and the literature was reviewed. Results In 8 patients, the main clinical manifestations were abdominal pain, bloating, abdominal mass and systemic consumption. 2 cases of preoperative ultrasound examination showed inhomogeneous ascites, and 4 cases of CEA were elevated. All patients were treated with surgery. Pathology confirmed that 7 cases were from appendiceal mucinous adenocarcinoma and 1 case was from descending colonic mucinous adenocarcinoma. Surgery includes resection of primary lesions, omentum, or other organs and removal of mucinous lesions as much as possible. All patients were treated with surgery. Postoperative adjuvant treatment included chemotherapy and radiotherapy. The postoperative follow-up rate was 10% (8/8), the 5-year survival rate was 50% (4/8), and the 10-year survival rate was 13% (1/8). Conclusion Peritoneal pseudomyxoma is a rare disease and it is difficult to diagnose preoperatively. B-ultrasound and CEA checks may help in diagnosis. Due to its low degree of malignancy and minimal metastasis, survival can be significantly improved after repeated aggressive surgery supplemented with chemotherapy and/or radiotherapy.