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目的探讨腹部恶性肿瘤继发脐转移 (sisterMaryJosephnodule ,SMJN)的临床病理特征、治疗和预后。方法对 1980年 1月至 2 0 0 3年 7月间 17例SMJN患者的临床资料进行回顾性分析。其中 10例行姑息性手术 ,7例未行手术治疗 ,比较姑息手术组与非手术组两者生存率。结果 17例脐转移灶均经病理确诊 ,其中 3例行脐结节穿刺细胞学检查。来源于卵巢上皮癌 6例 ,胃低分化腺癌6例 ,结肠腺癌 2例 ,子宫内膜癌 1例 ,胆囊癌 1例 ,1例诊断为低分化腺癌但未发现原发灶。姑息手术组中位生存期为 13 5个月 ,0 5、1、2年生存率分别为 6 0 %、2 0 %、10 % ;非手术组中位生存期 8 2 5个月 ,0 5年生存率为 14 3% ,无 1年生存者。姑息手术组预后好于非手术组 (P <0 0 1)。结论SMJN临床发生率低 ,是腹部恶性肿瘤终末期和预后差的标志。姑息性手术切除有望延长生存时间。
Objective To investigate the clinicopathological features, treatment and prognosis of malignant tumors of the abdominal wall (sister-jMJN). Methods The clinical data of 17 patients with SMJN between January 1980 and July 2003 were analyzed retrospectively. Among them, 10 patients underwent palliative surgery and 7 patients underwent no surgical treatment. The survival rates of both palliative and non-operative groups were compared. Results 17 cases of umbilical metastases were pathologically confirmed, of which 3 cases of umbilical cord biopsy cytology. 6 cases of epithelial ovarian cancer, 6 cases of poorly differentiated gastric adenocarcinoma, 2 cases of colon adenocarcinoma, 1 case of endometrial carcinoma, 1 case of gallbladder carcinoma, 1 case of poorly differentiated adenocarcinoma but no primary tumor. The median survival time in palliative surgery group was 13.5 months, and the 0, 1, 2 and 2-year survival rates were 60%, 20% and 10% respectively. The median survival time in non-operation group was 85.5 months and 0 5 The annual survival rate was 14.3% with no one-year survival. The palliative surgery group had a better prognosis than the non-surgical group (P <0.01). Conclusion The low incidence of SMJN is a marker of poor end-stage and poor prognosis of malignant abdominal tumors. Palliative surgery is expected to extend the survival time.