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目的研究生存期长的恶性胸膜间皮瘤(MPM)患者的特点。方法报告2010年1月大连市中心医院呼吸科收治的1例病程达10年之久并发胸腔积液的MPM病例并相关文献复习。结果患者男,77岁,反复活动后呼吸困难10年,加重2月,每年行2～4胸膜腔穿刺术检查,缓解症状,否认石棉接触史,肺CT:右胸腔积液伴包裹,余未见异常。胸腔镜检查镜下见脏层胸膜、壁层胸膜广泛半透明小结节样凸起,病理明确为上皮细胞型MPM。结合此例患者和文献复习,病理类型为高分化上皮细胞型和无石棉接触史的MPM患者生存期长。结论病理类型为上皮细胞型和无石棉接触史的MPM患者生存期长,研究生存期长的MPM患者的特点对识别影响肿瘤侵袭和生存期相关的独特的因素是有价值的。
Objective To investigate the characteristics of malignant pleural mesothelioma (MPM) patients with long survival. Methods One case of MPM with pleural effusion over 10 years admitted to Respiratory Department of Dalian Central Hospital in January 2010 was reviewed and related literatures were reviewed. Results The male patient, aged 77, had dyspnoea for 10 years after repeated activities, exacerbated in February and performed 2 to 4 pleural puncture tests every year to relieve the symptoms and deny the history of exposure to asbestos. CT of the lungs: right pleural effusion with parcels, Yu Wei See abnormalities. Thoracoscopic examination of the visceral visceral pleura, parietal pleura extensive translucent small nodular bulge, clear pathological epithelial cell type MPM. Combined with this patient review and literature review, patients with MPM who have a history of well-differentiated epithelial cell type and no history of asbestos exposure have long survival. Conclusions MPM patients whose pathological types are history of epithelial cell type and non-asbestos exposure have a long survival period and the characterization of long-lived MPM patients is valuable for identifying unique factors associated with tumor invasion and survival.