作者从1950～1980年的住院患者中发现148例恶性间皮瘤。25例(17%)为腹膜间皮瘤,其中男14,女11例,中位年龄49(16～80)岁。最常见的症状为腹部膨胀及腹痛(各7例)、可扪及腹部或盆腔肿块(4例),有时以不适、发热、乏力、体重减轻或便秘为首发症状。经剖腹探查诊断者最多,为19例,2例在疝修补术时发现,1例经腹腔穿刺及腹水检查诊断,3例仅在尸检时诊断。患者均无接触石棉或其他可引起间皮瘤物质的病史,以往均未作过腹部或盆腔的照射治疗。17例间皮瘤作了组织学分类,10例为上皮性,6例纤维肉瘤性,1例混合性。2例有异位性激素产生的症状,其中1例有反复的低血糖发作疑有胰岛素样物质产生,另1例有反复的低血钠和高血钾症,提示有异位性加压素(ADH)及促肾上腺皮质激素(ACTH)产生。19例在整个病程中肿瘤局限于腹部,另6例则播散到横膈以上,无一患者发生远处转移。19例作了剖腹并对肿瘤作了部份性切除,术中均见肿瘤有腹腔内播散,在术后加用其他治疗。7例应 The authors identified 148 cases of malignant mesothelioma from 1950 to 1980 inpatients. Twenty-five patients (17%) were peritoneal mesothelioma, including 14 males and 11 females with a median age of 49 (16-80) years. The most common symptoms were abdominal distension and abdominal pain (7 cases each), palpable abdomen or pelvic mass (4 cases), and sometimes discomfort, fever, fatigue, weight loss, or constipation as the first symptoms. Most diagnosed by laparotomy were 19 cases, 2 cases were found during hernia repair, 1 case was diagnosed by abdominal puncture and ascites, and 3 cases were diagnosed only at autopsy. The patients were not exposed to asbestos or other medical history that could cause mesothelioma. No abdominal or pelvic radiation therapy was used in the past. Seventeen cases of mesothelioma were histologically classified, 10 were epithelial, 6 were fibrosarcoma, and 1 was mixed. Two patients had symptoms of ectopic sex hormones. One patient had repeated insulin hypoglycemia and insulin-like substance production. The other patient had repeated hyponatremia and hyperkalemia, suggesting ectopic vasopressin ( ADH) and adrenocorticotropic hormone (ACTH) production. In 19 cases, the tumor was confined to the abdomen during the entire course of the disease, and the other 6 cases spread over the diaphragm. None of the patients had distant metastases. In 19 cases, laparotomy was performed and partial resection of the tumor was performed. During the operation, tumors were seen in the abdominal cavity, and other treatments were added after the operation. 7 cases should