超声在腹膜假黏液瘤术前病理分级中的应用价值
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摘要
目的研究腹膜假黏液瘤的声像图特征,分析超声检查在不同病理分级腹膜假黏液瘤诊断中的应用价值。方法术前对62例腹膜假黏液瘤患者进行超声检查,记录临床特点、声像图特征、剖腹术中表现及病理结果,根据术后病理结果,将研究对象分为高级别组及低级别组。对比术中表现分析腹膜假黏液瘤的声像图特征,分析不同级别腹膜假黏液瘤的声像图差异。结果肝脾周围压迹、盆腹腔包块及腹腔肿大淋巴结在两组中具有统计学差异,而是否出现网膜饼在两组中无统计学差异。腹水指数及网膜饼厚度在两组中具有统计学差异。肿瘤标记物CEA、CA125、CA199、CA724和CA242在两组患者中均升高,但两组间差异无统计学意义。结论术前超声检查对腹膜假黏液瘤的诊断具有一定的临床应用价值。不同病理级别腹膜假黏液瘤声像图特征有重叠,但有些声像图特征可以帮助鉴别诊断。
Objective To analyze the sonographic features of pseudomyxoma peritonei and the value of sonography in the pathologic staging of pseudomyxoma peritonei before surgery.Methods 62 patients with pseudomyxoma peritonei underwent sonographic examinations before surgery.According to the postoperative pathological results,the subjects were divided into the high-grade group and the low-grade group.The clinical factures,sonographic characteristics,representations in the surgery and pathologic grades were recorded.Then we compared sonographic characteristics with representations in the surgery and analysed the differences between different pathological level of pseudomyxoma peritonei.Results The liver or spleen pressure trace,the abdominal or pelvic mass and abdominal lymph nodes revealed statistically significant differences between different pathologic staging of pseudomyxoma peritonei,but the existence of "retinal cake" had no statistical difference.The thickness of "retinal cake" and ascites characteristics also had statistical difference.Carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),carbohydrate antigen 724(CA724)and carbohydrate antigen 242(CA242)raised in pseudomyxoma peritonei patients,but there is no statistical difference between different groups.Conclusions Preoperative sonographic examinations have some clinical application value in the diagnosis of pseudomyxoma peritonei.Ultrasonographic features in different pathologic staging of pseudomyxoma peritonei are overlap,but certain may help us to make some differential diagnosis.
Objective To analyze the sonographic features of pseudomyxoma peritonei and the value of sonography in the pathologic staging of pseudomyxoma peritonei before surgery.Methods 62 patients with pseudomyxoma peritonei underwent sonographic examinations before surgery.According to the postoperative pathological results,the subjects were divided into the high-grade group and the low-grade group.The clinical factures,sonographic characteristics,representations in the surgery and pathologic grades were recorded.Then we compared sonographic characteristics with representations in the surgery and analysed the differences between different pathological level of pseudomyxoma peritonei.Results The liver or spleen pressure trace,the abdominal or pelvic mass and abdominal lymph nodes revealed statistically significant differences between different pathologic staging of pseudomyxoma peritonei,but the existence of "retinal cake" had no statistical difference.The thickness of "retinal cake" and ascites characteristics also had statistical difference.Carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),carbohydrate antigen 724(CA724)and carbohydrate antigen 242(CA242)raised in pseudomyxoma peritonei patients,but there is no statistical difference between different groups.Conclusions Preoperative sonographic examinations have some clinical application value in the diagnosis of pseudomyxoma peritonei.Ultrasonographic features in different pathologic staging of pseudomyxoma peritonei are overlap,but certain may help us to make some differential diagnosis.
引文
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[2]Smeenk RM,Velthuysen ML,Verwaal VJ,et al.Appendiceal neoplasms and pseudomyxoma peritonei:a population based study.Eur Surg Oncol,2008,34(2):196-201.
[3]Chauhan A,Patodi N,Ahmed M.A rare cause of ascites:pseudomyxoma peritonei and a review of the literature.Clin Case Rep,2015,3(3):156-159.
[4]Fred T.Bosman,Fatima Carneiro,Ralph H.Hruban,et al.WHO Classification of Tumours of the Digestive System,2012,313-324.
[5]王欢,汪进良.39例腹膜假黏液瘤生存预后分析.中国现代手术学杂志,2013,17(1):13-17.
[6]Carr NJ,Cecil TD,Mohamed F,et al.A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia:The Results of the Peritoneal Surface Oncology Group International(PSOGI)Modified Delphi Process.Am J Surg Pathol,2015,21(11):364-372.
[7]Noguchi R,Yano H,Gohda Y.Molecular profiles of high-grade and low-grade pseudomyxoma peritonei.CancerMedicine,2015,16:1-8.
[8]Yoo E,Kim JH,Kim MJ,et al.Greaterand lesser omenta:normal anatomy and pathologic processes.Radiographics,2007,27(3):707-720.
[9]阙艳红,王学梅.腹膜黏液瘤的特征性超声表现探讨(附19例报告).中国超声医学杂志,2013,29(2):127-130.