CAJ | 학술논문

目的：探讨恶性间皮瘤的临床病理特点。方法：收集1985～2014年四川省肿瘤医院24例恶性间皮瘤患者的临床资料，回顾性分析患者的临床特点。结果：24例恶性间皮瘤患者中恶性胸膜间皮瘤18例，恶性腹膜间皮瘤6例；男17例，女7例，中位年龄52岁。恶性胸膜间皮瘤最常见症状为胸痛（7例），活动后气促（6例）。恶性腹膜间皮瘤最常见症状为腹胀（3例）。影像学特征最常见为胸腔或腹腔积液（14例）。胸、腹腔镜或剖胸、剖腹探查术确诊17例，胸壁或皮下包块活检术确诊5例，经胸水免疫细胞化学确诊2例。病理学分型：上皮型20例，混合型2例，未分型2例。初诊时7例患者误诊（29.2％），4例患者确诊前接受抗痨治疗（16.7％）。从发病到确诊中位时间3.3个月。21例患者接受化疗，1例行根治性手术，8例行姑息性手术，5例姑息性放疗。确诊至随访期结束中位生存时间为21个月。结论：恶性间皮瘤起病隐匿，确诊时多为局部晚期，无法行根治性手术，治疗以手术，放化疗多学科综合治疗为主，可改善症状，适当延长生存。
목적：탐토악성간피류적림상병리특점。방법：수집1985～2014년사천성종류의원24례악성간피류환자적림상자료，회고성분석환자적림상특점。결과：24례악성간피류환자중악성흉막간피류18례，악성복막간피류6례；남17례，녀7례，중위년령52세。악성흉막간피류최상견증상위흉통（7례），활동후기촉（6례）。악성복막간피류최상견증상위복창（3례）。영상학특정최상견위흉강혹복강적액（14례）。흉、복강경혹부흉、부복탐사술학진17례，흉벽혹피하포괴활검술학진5례，경흉수면역세포화학학진2례。병이학분형：상피형20례，혼합형2례，미분형2례。초진시7례환자오진（29.2％），4례환자학진전접수항로치료（16.7％）。종발병도학진중위시간3.3개월。21례환자접수화료，1례행근치성수술，8례행고식성수술，5례고식성방료。학진지수방기결속중위생존시간위21개월。결론：악성간피류기병은닉，학진시다위국부만기，무법행근치성수술，치료이수술，방화료다학과종합치료위주，가개선증상，괄당연장생존。
Objective:To investigate the clinicopathological characteristics of malignant mesothelioma (MM). Methods:Medical records of 24 malignant mesothelioma patients treated in our hospital from 1985 to 2014 were retrospec-tively reviewed.The clinical and pathological characteristics were analyzed.Results:Seventeen males and 7 females pa-tients were included in this study with a median age of 52 years.Eighteen patients were diagnosed as malignant pleural mesothelioma and 6 malignant peritoneal mesothelioma.Patients with malignant pleural mesothelioma presented most com-monly with chest pain (7 cases)and dyspnea after activities (6 cases),while abdominal distension (3 cases)occurred commonly in patients with malignant peritoneal mesothelioma.The most frequent radiological features were pleural effusion or peritoneal effusion (14cases).Seventeen cases were diagnosed via invasive procedures such as thoracoscopy,laparosco-py ,open pleural biopsy or open abdomen biopsy.Five cases were diagnosed via chest wall nodule or subcutaneous nodules excisional biopsy and 2 via pleural fluid immunocytochemistry.Pathological diagnoses included 20 cases of epithelioid sub-type ,2 biphasic sub-type and 2 non-specified sub-type.Seven cases (29.2%)were misdiagnosed at first visit and 4 pa-tients (16.7%)accepted anti-tuberculosis treatment before diagnosed.The median interval from start of complaints to diag-nosis was 3.3 months.Chemotherapy was administered to 21 patients,1 patient received radical surgery,8 patients re-ceived palliative surgery and palliative radiotherapy was given to 5 patients.The median survival from diagnosis to the end of follow up was 21 months.Conclusion:Malignant mesothelioma is an insidious tumor.A vast majority of MM patients are diagnosed in an advanced stage.The best treatment for the individual patient remains unknown.Multimodality treatment may alleviate symptoms and prolong the survival .