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1、实用癌症杂志2003年9月第18卷第5期ThePracticalJournalofCancer,September2003,Vol18,No.5·505·恶性胸膜间皮瘤29例分析黄进丰张德超林冬梅【摘要】目的探讨恶性胸膜间皮瘤诊断和治疗的临床特点。方法回顾性分析手术治疗29例恶性胸膜间皮瘤患者的临床资料。结果术后2年生存率为51.7%(15/29),5年生存率为31.0%(9/29)。手术并发症发生率为24.1%(7/29),无手术死亡者。接受根治术、姑息手术、探查术的患者5年生存率存在明显差异;
2、局限型患者5年生存率高于弥漫型患者。患者生存率与TNM分期明显相关。结论手术治疗恶性胸膜间皮瘤有效。国际间皮瘤研究组提出的新的恶性胸膜间皮瘤TNM分期标准客观且可行。Ⅰ、Ⅱ期患者适行手术治疗;Ⅳ期患者不适行手术治疗;对局限型、上皮型、估计手术能达到肉眼根治的Ⅲ期患者应考虑手术治疗。【关键词】恶性;胸膜间皮瘤;手术治疗中图分类号:R734.3文献标识码:A文章编号:1001-5930(2003)05-0505-03TreatmentofMalignantPleuralMesotheliomaand2
3、9CasesReportHUANGJin-feng,ZHANGDe-chao,LINDong-mei.CancerInstitute(Hospital),ChineseAcademyofMedicalScience(CAMS),PekingUnionMedicalCollege,Beijing,100021【Abstract】ObjectiveToinvestigatethediagnosisandtreatmentofmalignantpleuralmesothelioma.MethodsFro
4、mDe-cember1969toFebruary1998,29patientswithpathologicallyconfirmedmalignantpleuralmesotheliomaunderwentsurgicaltreat-mentinourhospital.Thefollow-upperiodwasatleast6months.ResultsTheoverallsurvivalrateswere51.7%at2yearsand31.0%at5years.Theoperativecomp
5、licationratewas24.1%withoutmortalityfromoperation.5-yearsurvivalratewassignificant-lydifferentbetweenpatientstreatedwithradicalresection,palliativepleurectomy,andexploratorythoracotomy.Thepatientswithlo-caltypehadasignificantlybettersurvivalrate(66.7%
6、for2-year;53.3%for5-year)thanthosewithdiffusetype(33.3%for2-year,11.1%for5-year).TheTNMstagingsystemhadacloserelationshipwithsurvivalrates.ConclusionSurgicalinterventionisap-propriatetreatmentforselectedpatientswithmalignantpleuralmesothelioma.TNMstag
7、ingsystemprovidesaninternationallyac-ceptedbasisfortheanalysisofsurvivalratesinprospectiveclinicaltrials.Pleurectomy/decorticationandextrapleuralpneumonectomyprovidegoodresultforpatientswithstageⅠorⅡ,exceptthosewithstageⅣ.ForpatientswithstageⅢ,radical
8、resectionisconsid-erableforthosewithlocaltypeandepithelialhistologicaltype.【Keywords】Malignant;Pleuralmesothelioma;Surgicalprocedures(ThePracticalJournalofCancer,2003,18:505～507)在胸部肿瘤外科领域,恶性胸膜间皮瘤的治疗一33例(其中行手术治疗者29例,未行手术者4例)。直是个棘手的问题。患者若不经治疗,中位
