| 摘要: |
| ［摘要］ 目的 分析单中心85例间皮瘤患者的临床病理特征及生存情况，探讨影响间皮瘤患者预后的因素。方法 回顾性分析2003年4月至2021年4月辽宁省肿瘤医院收治的85例间皮瘤患者的临床病理资料。结果 85例间皮瘤患者中，男42例，女43例，主要发病年龄为60～70岁。胸膜间皮瘤60例，腹膜间皮瘤25例。发病部位与病理组织学类型有关联性（χ2=9.671，P=0.008）。上皮样间皮瘤56例，肉瘤样间皮瘤9例，双相型间皮瘤20例。有淋巴结转移18例，无淋巴结转移67例。56例上皮样间皮瘤的病理组织学亚型以管状-乳头状为主（53.57%），低级别29例（51.79%）、高级别27例（48.21%），病理组织学分级与淋巴结转移有关联性（χ2=5.589，P=0.018）。85例间皮瘤患者总生存期为3～32个月，中位生存期为16.0个月，1年总生存率为70.10%，2年总生存率为36.50%。不同病理组织学类型、不同治疗方式的间皮瘤患者生存预后有显著差异（P<0.05），无淋巴结转移间皮瘤患者生存预后显著优于有淋巴结转移者（P<0.05）。胸膜间皮瘤患者中，无淋巴结转移者生存预后显著优于有淋巴结转移者（P<0.05），不同治疗方式的患者生存预后有显著差异（P<0.05）。腹膜间皮瘤患者中，不同病理组织学类型、不同治疗方式的患者生存预后有显著差异（P<0.05）。结论 胸膜间皮瘤多于腹膜间皮瘤，以上皮样间皮瘤为主，肉瘤样间皮瘤最少。上皮样间皮瘤患者生存预后较好，肉瘤样间皮瘤患者生存预后较差，有淋巴结转移的患者预后较差，手术联合化疗的治疗效果较好。上皮样间皮瘤病理组织学亚型多样，以管状-乳头状为主，高级别、低级别占比相近，低级别患者的中位生存期更长。 |
| 关键词: 间皮瘤 病理组织学亚型 病理组织学分级 生存分析 |
| DOI：10.3969/j.issn.1674-3806.2025.07.10 |
| 分类号:R 735.5 |
| 基金项目:国家癌症中心攀登基金临床研究课题（编号：NCC201806B008）；沈阳市科技计划项目（编号：21-173-9-08） |
|
| Analysis on clinicopathological data of 85 patients with mesothelioma in a single center |
|
MA Siyuan1,2,3, LIU Man3, HUANG Bo2
|
|
1.Department of Functional Teaching and Research, Medical College, Jinzhou Medical University, Jinzhou 121007, China; 2.Department of Pathology, Liaoning Cancer Hospital and Institute(Cancer Hospital of Dalian University of Technology), Shenyang 110042, China; 3.School of Basic Medicine, Shenyang Medical College, Shenyang 110034, China
|
| Abstract: |
| ［Abstract］ Objective To analyze the clinicopathological characteristics and survival of 85 patients with mesothelioma in a single center and to explore the influencing factors of prognosis in the mesothelioma patients. Methods The clinicopathological data of 85 patients with mesothelioma who were admitted to Liaoning Cancer Hospital and Institute from April 2003 to April 2021 were retrospectively analyzed. Results Among the 85 patients with mesothelioma, there were 42 males and 43 females, with the main onset age ranging from 60 to 70 years. There were 60 cases of pleural mesothelioma and 25 cases of peritoneal mesothelioma. There was a correlation between diseased site and histopathological type(χ2=9.671, P=0.008). There were 56 cases of epithelioid mesothelioma, 9 cases of sarcomatoid mesothelioma, and 20 cases of biphasic mesothelioma. There were 18 patients with lymph node metastasis and 67 patients without lymph node metastasis. The histopathological subtypes of 56 cases of epithelioid mesothelioma were mainly tubular papillary(53.57%), including 29 cases(51.79%) of low-grade epithelioid mesothelioma and 27 cases(48.21%) of high-grade epithelioid mesothelioma. There was a correlation between histopathological grading of epithelioid mesothelioma and lymph node metastasis(χ2=5.589, P=0.018). The overall survival of 85 patients with mesothelioma ranged from 3 to 32 months, with a median survival time of 16.0 months. The 1-year overall survival rate was 70.10%, and the 2-year overall survival rate was 36.50%. There were significant differences in survival prognosis among the mesothelioma patients with different histopathological types and different treatment methods(P<0.05). The mesothelioma patients without lymph node metastasis had significantly better survival prognosis than those with lymph node metastasis(P<0.05). Among the patients with pleural mesothelioma, the patients without lymph node metastasis had significantly better survival prognosis than those with lymph node metastasis(P<0.05), and there was significant difference in survival prognosis among the patients treated with different methods(P<0.05). In the patients with peritoneal mesothelioma, there was significant difference in survival prognosis among the patients with different histopathological types and there was significant difference in survival prognosis among the patients treated with different methods(P<0.05). Conclusion Pleural mesothelioma is more common than peritoneal mesothelioma, with epithelioid mesothelioma being the main type and sarcomatoid mesothelioma being the least. Patients with epithelioid mesothelioma have a better survival prognosis, while patients with sarcomatoid mesothelioma have a poorer survival prognosis, and patients with lymph node metastasis have a poorer prognosis. The therapeutic effect of surgery combined with chemotherapy is relatively good. Epithelioid mesothelioma has diverse histopathological subtypes, and the tubular papillary subtype is in the majority, with similar proportions of high-grade and low-grade cases. The patients with low-grade epithelioid mesothelioma have a longer median survival time than those with high-grade epithelioid mesothelioma. |
| Key words: Mesothelioma Histopathological subtypes Histopathological grading Survival analysis |
