恶性胸膜间皮瘤45例临床分析

BACKGROUND AND OBJECTIVE: Malignant pleural mesothelioma (MPM) is a rare tumor with increasing incidence, and its early diagnoses and early treatments are difficult. The aim of the current study is to investigate the clinical features, diagnoses, and treatments of MPM, and provide reference for clinical use. METHODS: A total of 45 MPM patients admitted in the Chinese PLA General Hospital from January 1997 to December 2010 and their clinical records were analyzed retrospectively. RESULTS: The major clinical symptoms of the patients included: chest pain (53.33%), chest distress (48.89%) and cough (37.78%). The CT manifestations of MPM included: pleural thickening (71.11%), pleural effusion (60%) and lung shadow (40%). The pleural fluid was exudative. The number of nucleated cells in the fluid increased, most of which were mononuclear cells. Moreover, the lactic acid dehydrogenase (LDH) levels in the culture medium significantly increased. The most common clinical stage of MPM patients was either stage of Ⅲ or Ⅳ. Thoracoscopy was one of the main diagnosis methods, and epithelium cell type was the main pathologic type. In addition, MPM was easily misdiagnosed as tuberculous pleurisy. Patients with an early stage of MPM were mainly cured through surgery, whereas chemotherapy was applied for the patients with advance stage. The disease control rate of the patients with epithelial type was higher than that of the patients with fibrosarcoma type. CONCLUSION: The rate of MPM misdiagnosis is high because most of the patients have untypical clinical symptoms. However, CT scan can provide an important basis for the diagnosis of MPM. The accurate diagnoses were based on pathological examinations and immunohistochemistry. The methods of treatment include chemotherapy, surgical operation, radiotherapy and supportive treatment. However, these treatments are still insufficient and require further studies.