12例卵巢外腹膜浆液性乳头状腺癌的诊断和治疗及预后

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1、12例卵巢外腹膜浆液性乳头状腺癌的诊断和治疗及预后许时赋(四川省成都安琪儿妇产医院四川成都610041)【中图分类号】R737.3【文献标识码】A【文章编号】1672-5085(2012)9-0183-02【摘要】目的探讨卵巢外腹膜浆液性乳头状腺癌(EPSPC)的诊断和治疗。方法12例患者均行剖腹探查术和配合化疗。手术前均采用PC、PAC方案化疗，根据病变情况选择不同的手术方式，即在切除全子宫、双侧附件、阑尾、大网膜后对直径大于1.0cm的肿瘤结节予以剔除，对于小于1.0cm的小结节则采用电凝烧灼;5例同时行盆腔淋巴结清扫术。关腹前将顺铂注入腹腔。术后继续采用PC、PAC方案

2、化疗。结果病理检查示5例细胞呈中等分化，7例呈低分化。子宫内膜均未见肿瘤侵润；9例卵巢结构正常，3例卵巢上皮浅表有肿瘤组织侵润。1例术后1月死亡；2例术后1月出现大量腹水，术后2+月死亡；2例失访；7例于术后5月至8月复发拒绝治疗并失访。结论手术是治疗EPSPC的首选方式,且有助于EPSPC的确诊。EPSPC手术治疗的原则与卵巢癌相同，均为肿瘤细胞减灭术，术前术后辅规范的化疗，有助于腹水吸收、病灶缩小，有助于手术及术后延长存活期，降低复发率。【关键词】卵巢外腹膜浆液性乳头状腺癌EPSPC诊断手术治疗术后化疗The12patientsovarianExtraovarianper

3、itonealseriouspapillaryCarcinoma(EPSPC)diagnosisandtreatmentandprognosisXUShifu(AngelObstetricsandGynecologyHospital,Chendusichuan610041,China)【Abstract】Objective:TodiscussovarianextraovarianperitonealseriouspapillaryCarcinomadiagnosisandtreatmentdiagnosisandtreatment.Methods:12patientswere

4、performedpaunchtoprobepeacewithchemotherapy.BeforetheoperationusingPC、PACschemechemotherapy,accordingtothediseaseconditionthepatientswerechosendifferentsurgicalresectionintheuterus,doubleaccessories,theappendix,theomentaloflcminthediameterafterthetumornodulestoeliminate,tolessthan1cmofsmall

5、nodules,theuseofelectricityburning.5caseswereperformedpelviclymphnodedissectionsline.Beforeabdominalcisplatinwasshutintotheabdominalcavity.PostoperativecontinuetothePC,PACchemothrepy.Results:Pathologicalexaminartionreealed5casesofcellaremediumdifferentiation,7casesoflowdifferentiation.Endom

6、etrialcancerisnotseeninfliltrating;9casesofovarianstructurenormal，3casesepithelialovariantumorinfiltrationaresuperficial.1caseafteronemonthdeath;2casesafteronemonth,ifalargeamountofascties,aftermore2monthsdeath;2caseslosttofollow-up;7casesunderwent5to8monthsrecurrencerefusedtotreatandlostto

7、follow-up;Conclusions:SurgeryisthefirstchoiceofEPSPCtreatment,andhelpfultothediagnosisofEPSPC.SurgicaltreatmentprinciplesofEPSPCisthesameasovriancancer,cancercellsaredestroyedreductiontechnique,andpostoperativerecoveryauxiliarystansdardchemotherapy,which