12例卵巢外腹膜浆液性乳头状腺癌的诊断和治疗及预后

12例卵巢外腹膜浆液性乳头状腺癌的诊断和治疗及预后

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

The 12 patients ovarianExtraovarianperitoneal serious papillary

Carcinoma(EPSPC)diagnosis and treatment and prognosis

XU Shifu

(Angel Obstetrics and Gynecology Hospital,Chendu sichuan 610041,China) 【Abstract】Objective:To discussovarianextraovarianperitoneal serious papillary Carcinoma diagnosis and treatment diagnosis and treatment.Methods:12 patients

were performed paunch to probe peace with chemotherapy.Before the operation using PC、PAC scheme chemotherapy,according to the disease condition the patients were chosen different surgical resection in the uterus ,double accessories,the appendix ,the omental of 1cm in the diameter after the tumor nodules to eliminate,to less than 1 cm of small nodules ,the use of electricity burning.5 cases were performed pelvic lymph node dissections line. Before abdominal cisplatin was shut into the abdominal cavity.Postoperative continue to the PC,PAC

chemothrepy.Results:Pathological examinartion reealed 5 cases of cell are medium differentiation,7 cases of low differentiation .Endometrial cancer is not seen infliltrating; 9 cases of ovarian structure normal，3 cases epithelial ovarian tumor infiltration are superficial.1 case after one month death; 2 cases after one month,if a large amount of ascties，after more 2 months death;2 cases lost to follow-up;7 cases underwent 5 to 8 months recurrence refused to treat and lost to follow-up; Conclusions: Surgery is the first choice of EPSPC treatment,and helpful to the diagnosis of EPSPC. Surgical treatment principles of EPSPC is the same as ovrian cancer,cancer cells are destroyed reduction technique,and postoperative recovery auxiliary stansdard chemotherapy,which help ascites bsortion,the lesion smaller,help the operation and to extend far，decrease the recurrence rate.

【key words】Extraovarianperitoneal serious papillary

Carcinoma EPSPC diagnosis operation treatment chemotherapy

卵巢外腹膜浆液性乳头状腺癌（EPSPC），是一种来源于腹膜，且是众多腹膜病变中的一种，临床表现与卵巢癌极为相似的疾病，也有良性、交界性及恶性之

分［1］。2003年1月—2010年12月，我们共收治的108例Ⅲb期以上卵巢癌患者，经手术证实12例为性腺外苗勒氏管肿瘤，也称卵巢外腹膜浆液性乳头状癌