CAJ | 학술논문

目的探讨卵巢外腹膜癌患者的临床误诊原因.方法回顾性分析19例卵巢外腹膜癌的临床表现、血肿瘤标志物、影像学特征、手术探查、病理学检查结果、治疗和预后.结果卵巢外腹膜癌最常见的临床表现为腹胀、腹痛和腹围增大.19例患者中,测定血中糖类抗原125(CA-125)者17例,15例升高,其中4例腹水中测得CA-125明显升高(＞104KU/L),12例腹水中找到癌细胞.19例患者中,有3例误诊为子宫来源肿瘤,13例误诊为附件肿瘤,1例误诊为膀胱、肠道来源肿瘤,其中仅有2例术前即诊断为腹膜肿瘤,误诊率89.47%(17/19).术后病理结果得以证实为腹膜恶性肿瘤,5年生存率仅20%.结论无明显诱因的腹胀腹痛是本病的主要临床表现,仔细的体格检查有时可以提供重要信息,异常增高的血CA-125水平及腹水穿刺结果有助于卵巢外腹膜癌的诊断和鉴别诊断,CT对腹膜原发灶具有诊断价值.
목적 탐토란소외복막암환자적림상오진원인.방법 회고성분석19례란소외복막암적림상표현、혈종류표지물、영상학특정、수술탐사、병이학검사결과 、치료화예후.결과 란소외복막암최상견적림상표현위복창、복통화복위증대.19례환자중,측정혈중당류항원125(CA-125)자17례,15례승고,기중4례복수중측득CA-125명현승고(＞104KU/L),12례복수중조도암세포.19례환자중,유3례오진위자궁래원종류,13례오진위부건종류,1례오진위방광、장도래원종류,기중부유2례술전즉진단위복막종류,오진솔89.47%(17/19).술후병리결과 득이증실위복막악성종류,5년생존솔부20%.결론 무명현유인적복창복통시본병적주요림상표현,자세적체격검사유시가이제공중요신식,이상증고적혈CA-125수평급복수천자결과 유조우란소외복막암적진단화감별진단,CT대복막원발조구유진단개치.
Objective To analyze the misdiagnosis in extraovarian peritoneal carcinoma(EOPC). Methods The clinical manifestation, blood tumor marker, imaging examination, laparotomy, pathology, treatment and prognosis of 19 EOPC patients were retrospectively analyzed. Results The clinical symptoms were abdominal distention, abdominal pain and swelling. 17 cases were tested for blood CA-125 with 15 at abnormaly high level, and in 4 cases ascites was CA-125 positive ( ＞ 10 KU/L). Tumor cells were detected in the ascites in 12 cases. Three cases were misdiagnosed as of uterine origin, 13 cases misdiagnosed as adnexal tumor, 1 case was misdiagnosed as bladder and intestinal tumor. Only 2 cases were correctly diagnosed before the operation. All of the cases were pathologically proved as peritoneal carcinoma. The five-year survival rate was only 20 percent. Conclusions Abdominal distention and pain with unknown causes were the primary manifestations of EOPC, elaborate physical examination sometimes may provide with important information. The significant elevation of serum CA-125 and the ascites cytology may be helpul for the differential diagnosis of PPC. CT scan is valuable for the diagnosis of EOPC.