腹膜间皮瘤

腹膜间皮瘤 一，【腹膜间皮瘤】 腹膜间皮瘤(peritoneal mesothelioma) 为原发于腹膜上皮和间皮组织的肿瘤，临床很少见。病理上可将之分为腺瘤样间皮瘤(adenomatoid mesothelioma)、囊性间皮瘤(cystic mesothelioma)和恶性间皮瘤(peritoneal malignant mesothelioma,PMM)。前两者属良性肿瘤。 囊性间皮瘤多见于女性，病因不明，好发于盆腔或附件周围，呈单个或多个囊性肿块;病人常因扪及腹块而就诊。PMM约占恶性间皮瘤之30%;其发生也与接触石棉有密切关系，约5%病人有接触史;石棉纤维经口摄入后，通过肠壁易位到腹膜而致病。从接触石棉到确诊，本病潜伏期可长达25,40年之久。但国内1951,1993年20篇文献161例PMM中仅1例有石棉接触史。在无石棉接触史的人群中，其发病率约1人/1百万人•年，可能与某些病毒感染及遗传因素有关。国外曾报告1例PMM病人40余年前曾接触过胶质二氧化钍(Thorotrast)。PMM常发生于40岁以上男性。脏层或壁层腹膜均可罹及;肿瘤可直接侵犯腹、盆腔脏器;50%,70%病人伴淋巴和(或)血行转移远处如肝、肾、肾上腺、肺、骨和淋巴结等。病因与石棉接触有关其发病与接触的间隔很长常在30年以上。 二，【腹膜间皮瘤是怎么造成的，酸性体质与脑癌的关系】 长期的饮食结构，生活习惯等因素造成体质酸化，人体整体的机能下降，引起身体器管的局部病变，当腹膜部位日积月累沉积大量的酸性物质以后，就造成了该部位的病变。 身体组织液酸化，脑细胞处于酸性体液中，进而形成腹膜间皮细胞溶氧量下降，造成细胞的活性下降，代谢循环减慢，下降到正常值的65,时，正常细胞就无法生存，但也有不惜改变染色体采取主动变异的细胞，细胞的表型发生改变，肿瘤性状得以表达，这些细胞迅速扩增，从而形成真正的肿瘤实体。 另外，还有因体质酸化身体发生其他组织的癌变，又因身体部分机能下降，腹膜间皮组织液酸化，癌细胞趁虚而入，造成了腹膜间皮瘤。 三，【腹膜间皮瘤的临床症状】 本病临床表现缺乏特异性，可有腹痛、便秘、腹胀、体重减轻及其他肠梗阻表现。体检可发现腹水或腹块等。腹水为渗出液，部分为血性。本病易误诊为结核性腹膜炎、复发性自发性腹膜炎、肠系膜炎症或腹膜转移癌等。 临床症状: 1(不明原因的腹痛、腹胀和消化道功能紊乱，腹痛可表现为多样化，但腹痛的顽固性是其共同特点。腹水的发生率很高，在90%以上，在一个可长可短的腹痛期后，突然出现腹水，但腹水也可在早期单独出现。腹水量多且顽固。全身情况在较长时期内很少变化，食欲可保持，消瘦不明显，无发热，有时可发生自发性低血糖症。可伴有胸痛、呼吸困难、咳嗽等胸膜间皮瘤症状。 2(体检发现 腹部膨隆，或呈蛙腹，移动性浊音阳性;腹部触诊可触及大小不等的单个或多个肿块，一般压痛不明显。如伴有胸膜间皮瘤，则可发现胸水的阳性体征。 3(B超和CT检查 可发现薄片状肿物图像和腹水。腹水为渗出液，也可为血性。腹水中透明质酸如增高至120ug/ml，对诊断很有帮助。腹水中找到新生物性间皮瘤细胞具有诊断价值，也可对腹水中间皮细胞染色体进行，有助于诊断。腹腔镜检可见腹膜表面满布结节和斑块，活检病理检查可证实诊断。需注意与结核性腹膜炎、腹膜转移瘤相鉴别。 四，【如何预防腹膜间皮瘤】 研究表明: ? 癌症不能在弱碱性的人体中形成; ? 癌症只能在酸性身体中形成; ? 如果你有癌症，说明身体是酸性的; ? 癌症只能在一个酸性的身体扩展; ? 如果你的身体变弱碱性，癌症不能扩展; ? 如果你能平衡你的身体PH值，让你的身体转变成弱碱性，不管你得的是什么癌症都有转变和被治好; ? 不管你的情况多么糟糕，哪怕只能活6个月，如果你能转变你的身体PH值到弱碱性，你的癌症就不会扩展，就会好; ? 不用担心你的家族中你的妈妈、爸爸或任何人有癌症，只要你的身体是弱碱性的，你不会得，如果你已经有了，它将会转变; ? 癌症都是酸性体液中生存的，没别的。如果你的身体是酸的，你就会得癌症。如果是弱碱的，你就不会得癌症。如果你已有了癌症，只要你能调整你身体的PH值到弱碱性，癌症就会离你而去。 预防癌症的秘诀十分简单，就是常吃碱性食物以防止酸性废物的累积，因为酸化的体液环境，是正常细胞癌变的肥沃土壤，调整体液酸碱平衡，是预防癌症的有效途径。 A) 养成良好的生活习惯，戒烟限酒。吸烟，世界卫生组织预言，如果人们都不再吸烟，5年之后，世界上的癌症将减少1/3;其次，不酗酒。烟和酒是极酸的酸性物质，长期吸烟喝酒的人，极易导致酸性体质。 B) 不要过多地吃咸而辣的食物，不吃过热、过冷、过期及变质的食物;年老体弱或有某种疾病遗传基因者酌情吃一些防癌食品和含碱量高的碱性食品，保持良好的精神状态。 C) 有良好的心态应对压力，劳逸结合，不要过度疲劳。可见压力是重要的癌症诱因，中医认为压力导致过劳体虚从而引起免疫功能下降、内分泌失调，体内代谢紊乱，导致体内酸性物质的沉积;压力也可导致精神紧张引起气滞血淤、毒火内陷等。 D) 加强体育锻炼，增强体质，多在阳光下运动，多出汗可将体内酸性物质随汗液排出体外，避免形成酸性体质。 E) 生活要规律，生活习惯不规律的人，如彻夜唱卡拉OK、打麻将、夜不归宿等生活无规律，都会加重体质酸化，容易患癌症。应当养成良好的生活习惯，从而保持弱碱性体质，使各种癌症疾病远离自己。 F) 不要食用被污染的食物，如被污染的水，农作物，家禽鱼蛋，发霉的食品等，要吃一些绿色有机食品，要防止病从口入。 五，【腹膜间皮瘤的诊断及得了腹膜间皮瘤怎么办】 腹膜间皮瘤是指原发于腹膜间皮细胞的肿瘤。临床表现不具有特征性，常见的症状和体征有:腹痛、腹水、腹胀及腹部包块等。 腹膜间皮瘤是指原发于腹膜间皮细胞的肿瘤。临床表现不具有特征性，常见的症状和体征有:腹痛、腹水、腹胀及腹部包块等。 腹膜间皮瘤约占所有间皮瘤病例的20%，可发生于2-92岁，平均年龄为54岁，其中约63%的病例在45-64岁之间，儿童患病者罕见。 在日常生活中，定期去体检，时常注意自己的身体有无腹膜间皮瘤的征兆，如果有一些反应就要弄清楚到底是什么原因造成的不适。要确诊是不是脑癌需要到医院去做具体的检查，看自己的血检指标，CEA，CA125，做核磁共振等检查确诊。 如果确诊是腹膜间皮瘤，首先不要慌，一定要根据具体的情况做判断应该如何治疗，进行多方面的咨询。一般肿瘤不易做手术，特别是肿瘤大的已经压迫神经的或者靠近大血管的情况。建议保守治疗，进行食疗。 六，【食疗法治疗腹膜间皮瘤】 今天我们治疗癌症所采取的手术和化疗为什么没有真正的治愈癌症，减轻患者的痛苦呢，人们最终没有得到康复的真正原因就是体液是酸化的，酸性体液不改变癌细胞也就不会死亡，这就是因为做了手术和化疗后癌细胞再度转移和复发的原因。要治疗癌症还得从改善自身的体质开始，从源头上饿死癌细胞。多吃碱性食品，改善自身的酸性体质，同时补充人体必须的有机营养物质，这样才能在饿死癌细胞的同时，恢复自身的免疫力。 七，【常见的酸性食物与碱性食物】 1.强酸性食品:蛋黄、奶酪、白糖做的西点或柿子、乌鱼子、柴鱼等。 2.中酸性食品:火腿、培根、鸡肉、鲔鱼、猪肉、鳗鱼、牛肉、面包、小麦、奶油、马肉 等。 3.弱酸性食品:白米、落花生、啤酒、酒、油炸豆腐、海苔、文蛤、章鱼,泥鳅。 4.弱碱性食品:红豆、萝卜、苹果、甘蓝菜、 洋葱、豆腐等。 5.中碱性食品:萝卜干、大豆、红萝卜、蕃茄、 香蕉、橘子、番瓜、草莓、蛋白、梅干、柠檬、菠菜等。 6.强碱性食品:恰玛古、葡萄、茶叶、海带芽、海带，柠檬等。 囊性间皮瘤的治疗方法 Treatment of Cystic Mesothelioma 手术切除囊性肿块效果甚佳， 无手术后死亡的报道。但25%病人术后局部复发。 Van der Klooster 等报告1例多发性囊性间皮瘤病人，经抽吸和闭塞治疗均无效，1年内肿瘤复发5次，最后 改用经阴道插管 持续引流，终将之治愈。手术切除囊性肿块效果甚佳，无手术后死亡的报道。但25%病人 术后局部复发。 目前经腹腔镜也能完整切除巨大腹腔囊性间皮瘤。 Surgical excision of cystic mass effect is very good and without postoperative deaths reported. But 25% of patients with local recurrence. Van der Klooster reports on one cases with multiple cystic mesothelioma patients. by suction and occlusion treatment were ineffective, a tumor recurrence five years times, the last to switch to vaginal intubation continuous drainage, eventually cure. Surgical excision of cystic mass effect is very good and without postoperative deaths reported. But 25% of patients with local recurrence. With laparoscopy can complete resection of giant cystic peritoneal mesothelioma. 恶性间皮瘤 Malignant Mesothelioma 手术疗法 Surgical therapy 对I、?期PMM首选手术治疗。术式包括减瘤手术(cytoreductive surgery)，尽可能切除 所能见到的 肿瘤组织。但事实上因手术难度大，病变弥漫，难以达到完全切除的目的。对复发者可再次 手术。对肠 梗阻者可行姑息性手术，缓解梗阻症状。 Right I, Phase II analyzing the preferred surgical treatment. Operation include the reduction of tumor surgery (cytoreductive surgery), possible removal can see the tumor tissue. But because of the difficulty in surgery, diffuse lesions, the complete resection difficult to achieve the objective. Right recurrence can be re-operation. Ileus is feasible right palliati ve surgery, obstructive symptoms. 放射疗法 Radiotherapy PMM对放疗欠敏感，放疗效果不如胸膜间皮瘤。 但对手术未能完全切除病灶或无法 手术者，放疗仍不 失为一种重要疗法。方法包括外照射和(或)内照射。外照射一般选用60Co或186KV X线作 为放射源，视病 变范围选择全腹或局部照射。 上医大肿瘤医院给病人全腹照射，6,7周内照射剂量达24 戈瑞(Gy)，结果 局部复发率降至11.4%，3年生存率提高至66.7%。放疗可引起放射性肠炎、放射性脊髓炎 和放射性肝炎等。 腹腔内注射核素如32P或198Au，通过内放射，使间皮瘤组织和小血管硬化，并杀伤腹水中 的游离瘤细胞， 使病情获得短期缓解。但此法需一定设备，且代价不菲，并可抑制骨髓，现已少用。 SILVER less sensitive to radiotherapy, radiotherapy result is not as good as pleural mesothelioma. But the surgical resection of the lesions has not been fully or not surgery, radiotherapy is nonetheless an important therapy. Including external irradiation and (or) irradiation. External irradiation generally choose 60 or 186KV Co. as X-ray sources, depending on the scope of diseases to choose partial or whole abdominal irradiation. Medicine tumor patients to the hospital whole abdominal irradiation, six-seven weeks of radiation doses up to 24 gray (Gy). Results of local recurrence rate to 11.4%, three-year survival rate increased to 66.7%. Radiotherapy can cause abdominal radiation, radioactive radiation myelitis and hepatitis. Intraperitoneal injection of radionuclide P as 32 or 198 Au, through radiation and mesothelioma organizations and small vascular sclerosis. and the anti-free ascites tumor cells, a short-term illness mitigation. But this method will need equipment, and the price is very expensive, and can inhibit the bone marrow, has been seldom used. 化学疗法 Chemotherapy 药物 PMM对化疗中度敏感.术前诱导化疗、术中和术后辅助化疗可明显减少肿瘤复发, 提高3年存活率。 Drug analyzing moderately sensitive to chemotherapy. Pre-operative chemotherapy, surgery and post-operative adjuvant chemotherapy can significantly reduce tumor recurrence, three years to improve the survival rate. 治疗PMM效果肯定的化学药物有阿霉素、顺氯氨铂、卡铂、博莱霉素及国产抗癌新药榄香烯乳等。 长 春新碱、氟脲嘧啶、环磷酰胺、丝裂霉素等也值得一试。 SILVER certainly result in the treatment of chemical drugs doxorubicin, cisplatin and carboplatin, bleomycin and a new anticancer drug Eiemene other. Vincristine, fluorouracil, cyclophosphamide, mitomycin also worth a try. 阿霉素(Adriamycin, ADM) 成人每次30,60mg/m2，每3周1次，静脉或腹腔注射，总剂量不超过 550mg/m2。不良反应以心脏毒性为著,且有积聚性,与总剂量有关;其次为抑制骨髓、胃肠道反应及脱发等。 Doxorubicin (Adriamycin, ADM) for each adult 30 ~ routinely. Every three weeks one time, intravenous or intraperitoneal injection of a total dose of not more than 550mg/m2. Adverse reaction to a cardiac toxicity, there is accumulation, with the total dose; Followed by bone marrow suppression. gastrointestinal reactions and alopecia. 顺氯氨铂(Cisplatin, DDP, 顺铂) 成人每次80,120mg/m2，每3周1次;或20mg/m2，连用5天，每 3周 为一疗程，静脉注射。不良反应有肾毒性、耳毒性、神经毒性、胃肠道反应和抑制骨髓等。加用甘露醇可 减少其在肾小管中积聚。该药也常用于腹腔内注射，具体方法见下文。 PDD (cisplatin, DDP, cisplatin) for each adult 80 ~ 120mg/m2, every three times a week; or 20 mg/m2 for 5 days every 3 weeks for a course of treatment, intravenous injection. Adverse reactions are nephrotoxicity and ototoxicity, neurotoxicity, gastrointestinal reactions and bone marrow suppression. Plus mannitol to reduce its accumulated in the tubular cells. The drug is commonly used in the intraperitoneal injection, the specific method described below. 卡铂(Carboplatin, CBP) 成人每次300,400mg/m2，加入5%葡萄糖溶液或生理盐水中，稀释为浓度 0.5mg/ml的溶液，静脉滴注，每3,4周重复;或100mg/d，加入5%葡萄糖溶液500ml中静脉滴注，连用 5天; 3,4周重复1次。也可每次用300,500mg腹腔内注射，每周1次。 Carboplatin (Carboplatin, CBP) Adult 300 ~ 400mg/m2 each. by adding 5% glucose solution or saline, diluting the concentration of the solution 0.5mg/ml, intravenous drip, Each three-four weeks duplication; or 100 mg / d, to 5% glucose solution 500ml intravenous drip for 5 days; 3 ~ 4 times a week to repeat. Can be used for each 300 ~ 500 mg intraperitoneal injection once a week. 博莱霉素(Bleomycin, BLM) 成人用15,30mg，溶于适量生理盐水或5%葡萄糖溶液中深部肌注、静注 或静脉滴注，每周2次;也可根据情况改为1次/d或每周数次。还可用60mg溶解后缓慢注入腹腔。Stey 用BLM 腹腔内注射，治疗1例PMM病人，结果腹水消失，停药后未再出现，存活已逾3年。但大剂量BLM腹腔 内注射 可引起肺炎样症状，甚至肺纤维化;此外，发热、胃肠道反应较常见，个别病人发生变态反应。 Bleomycin (hopefully, the BLM) Adult use 15 ~ 30mg, dissolved in saline or modest 5% glucose solution deep intramuscular, or intravenous injection two times a week; also, under the circumstances, to a time / d or several times a week. Can also be dissolved after 60 mg intraperitoneal injection of slow. Stey with BLM intraperitoneal injection, treatment one cases analyzing patient outcome ascites disappeared, the withdrawal did not arise again. survived for more than three years. But BLM large dose intraperitoneal injection can cause pneumonia-like symptoms, or even pulmonary fibrosis; In addition, fever, gastrointestinal reactions more common. Patients allergic individual. 紫杉醇(Paclitaxel) 本品是从红豆杉树皮中提取的抗癌药，通过诱导和促进微管蛋白聚合，防止解 聚和稳定微管，抑制了细胞有丝分裂和增殖。紫杉醇还能抑制有丝分裂所需的微管网再生，妨碍有丝分裂 纺锤体的形成导致染色体的断裂，抑制了肿瘤细胞的复制。剂量为135,175 mg/m2，稀释于生理盐水或5% 葡萄糖溶液中静脉注射。每3周重复。用药前12小时应给予地塞米松20 mg，30,60分钟前应静注苯海 拉明 50 mg和西米替丁300 mg或雷尼替丁200 mg，以防过敏反应。与顺铂合用对约66.7%的病人有效，并能 耐受 其毒性反应[6]。不良反应有抑制骨髓、过敏反应、关节痛、肌痛、胃肠道反应、周围神经病变、昏厥、共 济失调及注射部位肿痛等。 Taxol (paclitaxel) to be from the yew bark extract anticancer drug induce and promote tubulin polymerization and depolymerization and prevent stable microtubules, inhibit cell proliferation and mitosis. Taxol can inhibit mitosis of the microtubule network renewable, prevent mitotic spindle lead to the formation of chromosome break, inhibit the replication of tumor cells. Dose of 135 ~ 175 mg/m2, diluted in normal saline or 5% glucose solution was injected into the vein. Repeated every 3 weeks. 12 hours before the treatment should be given dexamethasone 20 mg, 30 ~ 60 minutes before intravenous diphenhydramine 50 mg and cimetidine 300 mg or 200 mg of ranitidine. to prevent allergic reactions. And cisplatin combination of about 66.7% of the patients effectively, and the ability under toxicity [6]. Adverse reactions inhibit bone marrow, allergies, joint pain, muscle pain, gastrointestinal reactions, peripheral neuropathy, syncope, Ataxia and the injection site pain and so on. 榄香烯乳(Elemene) 为中药莪术中提取到的抗癌活性物质;胸、腹腔内灌注治疗恶性胸、腹水有较好 疗效。在尽量抽除腹水后，按200,400mg/m2用量注入腹腔，每周1,2次。不良反应发生率为20%,70%， 主 要有发热、畏寒和局部疼痛;如预先注入少量麻醉药和激素，则能预防之;其他有过敏反应、胃肠道反应等。 Eiemene (Elemene) curcuma extract of the anticancer activity of substances; Chest, intraperitoneal infusion treatment of malignant thoracic, ascites has a good effect. In addition to pumping as much as possible in ascites, according to 200 ~ 400mg/m2 intraperitoneal injection dosage, the weekly one-two times. Adverse reaction rate of 20% ~ 70%, mainly fever, chills and pain; If pre-anesthetic and inject a small amount of hormones, it will Prevention; other allergic reactions, gastrointestinal reactions. 环磷酰胺(CTX) 成人每次600,1200mg，每周1,2次， 静脉注射。用药后抑制骨髓、胃肠道反应 及出血性膀胱炎等不良反应均较常见。 Cyclophosphamide (CTX) for each adult-1200mg 600, the weekly one-2nd, intravenous. After administration of bone marrow suppression, gastrointestinal reactions and stopped the bleeding bladder are more common adverse reactions. 长春新碱(VCR) 成人每次2.5,8mg/m2，每周1次，静脉注射 ，总量为60,80mg，主要不良反 应 为抑制骨髓。 Vincristine (VCR) for each adult 2.5 ~ 8mg/m2, a weekly meeting, intravenous, The total amount of 60- 80mg, the main adverse reaction to the suppression of bone marrow. 甲氨喋呤(MTX) 成人每次15,50mg，每周1,2次，肌肉或静脉注射。副作用有骨髓抑制、胃肠道 反应、 口腔炎、肝肾功能损害等，长期用药可致肺纤维化。 Methotrexate (MTX) for each adult 15-50mg, a weekly two-time, muscle or intravenous injection. Side ef fects are bone marrow suppression, gastrointestinal reactions, stomatitis, liver and kidney dysfunction, long -term medication can be induced pulmonary fibrosis. 化疗方法 有以下两种。 Chemotherapy following two methods. 全身化疗 全身给予抗癌药后，腹膜腔内药物分布较少。国外报告，无论单药或联合用药，全身化疗有 效率仅11,,14%。 联合化疗包括:DDP+ADM，DDP+CTX+VCR，CTX+VCR+BLM等。但不少学 者强调，联合 化疗并不能提高疗效[11]。 Poulain等[12]体外研究了DDP、CBP和两性霉素B(AmB)对恶性间皮瘤细胞株 的细 胞毒性作用。给细胞株接触上述药物2小时，6天后得到的生长—抑制曲线表明，浓度为5,10mg/L的A mB对敏 感的或耐药的细胞株，都可使DDP和CBP的50%生长—抑制浓度(IC50)降低5,10倍。 AmB的作用可能 与其显著 增加了肿瘤细胞对铂的摄入，提高了细胞内铂的浓度，增强了铂的细胞毒性作用有关。磷酸二酯酶抑制性 甲 基黄嘌呤(phosphodiesterase inhibiting methylxanthines) 与AmB有协同作用，其本身毒性弱，且能缓解 AmB的肾毒性。 但迄今未见临床联合应用上述药物的报告。 Systemic chemotherapy for systemic anticancer drugs, drug distribution peritoneal cavity less. Abroad, whether single or combined drug treatment, chemotherapy efficient only 11% ~ 14%. Combined chemotherapy include : ADM + DDP, DDP + CTX + VCR, CTX VCR + + BLM etc.. But many scholars stressed that the combined chemotherapy and would not improve efficacy [11]. Poulain, etc. [12] In vitro studies of the DDP, CBP and amphotericin B (mg) of malignant mesothelioma cells in vitro. Access to the cells of these drugs two hours, six days after the growth-inhibition curve, concentration of 5 ~ 10 mg / L mg of sensitive or resistant cell line, DDP can enable CBP and the 50% growth-inhibitory concentration (IC50) to reduce 5 ~ 10 times. Mg role may increase significantly with a pair of platinum tumor cell uptake and improve the intracellular concentration of platinum, enhance the cytotoxicity of cisplatin in the role. Phosphodiesterase inhibition methylxanthine (phosphodiesterase inhibitin g methylxanthines) mg a synergistic effect, its own weak toxicity, able to ease mg of renal toxicity. But so far no clinical drug combination of the above report. 腹腔内化疗 近年认为， 腹腔内注射用药可提高局部药物浓度，减轻全身不良反应;不仅能消灭手术 后残留的肿瘤组织，减少复发;还可使部分失却手术机会的病人肿块缩小，腹水减少，病情得到有效控制。 腹腔内用药剂量与静脉一次用量相似，或略高于后者;,周后重复。根据病情可连续注射数周。Ito[13]等 给1例手术未能切除的PMM 病人腹腔注射DDP， 并联合应用了 尿嘧啶 和tegafur，取得了意想不到的 效果: 在术后223天腹块和腹水完全消失。但在第8个月后盆腔肿块复发;重新给予DDP和喜树碱，效果却不佳。 ,a等[14]则用加温持续腹腔灌注 ( continuous hyperthermic peritoneal perfusion, CHPP)联合DDP 局部注射，治疗PPM。 灌注初始DDP平均量为120mg/ml(81,166mg/ml),灌注流量1.5L/min，平均灌注量 为 5.1L(4,7L)，灌注90分钟后， 测量腹腔内三处温度分别为41.5?、40.5?和41.1?。灌注液总DDP曲 线 下面积(AUC)为血浆DDP AUC的21倍，血浆DDP浓度则与全身用药时相仿。治疗过程中无明显局部不 良反应， 病人均能耐受CHPP。随访10个月，无1例因CHPP治疗而死亡。Park 等[15]也有类似的报道。目前看来， CHPP不啻为治疗PMM的一个有效方法。 Intraperitoneal chemotherapy in recent years that the intraperitoneal injection of medication may improve the local drug concentration and reduce systemic adverse reactions; not only can eliminate postoperative residual tumor tissue, reduce relapse; may lose some of the surgical patients mass reduced, ascites, the condition was under control. Intraperitoneal and intravenous dose of a similar amount, or slightly higher than the latter; A week later to repeat. Under the condition can be continuous injection of a few weeks. Ito [13], so as to not one cases surgical resection of analyzing patients intraperitoneal injection of DDP, and the combination of uracil and tegafur, made unexpected effect : 223 days after the abdominal mass and ascites completely disappear. But in the first eight months after pelvic tumor recurrence; Restore DDP and camptothecin, the result is poor. Ma, and so on [14] used a continuous warming peritoneal perfusion (continuous hyperthermic peritoneal perfusion, CHPP) combined with cisplatin injection. PPM treatment. DDP initial perfusion average volume of 120 mg / ml (~ 81 166mg/ml), .5L/min a perfusion flow rate, the average amount of reperfusion 5.1L (4-7L), 90 minutes after reperfusion. Measurement intraperitoneal three temperature of 41.5 ? C, 40.5 ? C and 41.1 ? C. Perfused with DDP total area under the curve (AUC) for plasma AUC DDP 21 times, DDP plasma concentration and systemic medication when similar. The course of treatment no local adverse reactions, patients were able to tolerance CHPP. Follow-up of 10 months, no cases of death CHPP treatment. Park and so on [15] also have similar reports. Currently, the CHPP analyzing the results of the treatment of one of the effective ways. 生物反应修饰疗法 Bioreactor modification therapy 生物反应修饰剂(biological response modifier, BRM) 是体内自身的一些细胞和分子，能应答机 体对内外环境的刺激，并参与维持机体内环境的稳定。BRM通过调动机体固有能力抵御和消灭肿瘤，成为 当 今治疗肿瘤的新模式。随着细胞和基因工程的进展，BRM在肿瘤治疗领域大有用武之地。 Biological response modifiers (biological response modifier, BPM) is the body's own cells and molecules, the body of the response to internal and external stimuli in the environment. and in vivo environment f or the maintenance of stability. BRM through the mobilization of the body inherent ability to resist and eliminate tumor, the treatment of cancer has become the new model. With cell engineering and genetic engineering progress, BRM in the field of cancer treatment can be fully utilized. 细胞因子 白细胞介素(IL)、干扰素(IFN)、 肿瘤坏死因子(TNF)等除能直接杀伤瘤细胞外，并能活化 体内抗癌细胞， 或分泌抗癌效应分子，或维持免疫效应细胞增殖分化功能，可作为PMM的辅助疗法。 Cytokine interleukin (IL), interferon (IFN), Tumor necrosis factor (TNF), in addition to directly kill tumor cells, and can be activated in vivo cancer cells, or secreted molecule anticancer effect, or maintaining immune effector cell proliferation and differentiation of functions, can be used as adjuvant therapy analyzing. 过继转移的免疫细胞 收集、分离癌性腹水中的淋巴细胞，在体外扩增，并诱导出具杀伤活性的淋巴因 子活化杀伤细胞(LAK细胞)，将之注入体内，有杀伤瘤细胞的作用。同时给予IL—2，可提高疗效。Tani[1 6] 等将淋巴细胞与病人自身恶性间皮瘤细胞混合培养，加以抗CD3单克隆抗体和IL—2激活之， 生成细胞 毒性 T细胞(CTL)。激活的CTL对自身恶性间皮瘤细胞有高度细胞毒性作用。作者给2例PMM病人化疗的同时， 腹腔 内注射CTL作为辅助疗法，结果腹水消退，瘤块逐渐消失，改善了患者的生存质量。 Adoptive transfer of immune cells collection, separation, ascites carcinoma of lymphocytes in vitro amplification, issued and induced cytotoxic activity of lymphokine-activated killer cells (LAK cells), to be injected into the body. anti-tumor cells. Given IL-2 may improve the outcome. Tani [16] will be the lymphocytes of patients with malignant mesothelioma cells themselves mixed culture, to be anti-CD3 monoclonal antibody and IL-2 activate it, the generation of cytotoxic T cell (CTL). CTL activation of the cell's own malignant mesothelioma cells with high toxicity. Author to analyzing two cases of chemotherapy patients, while intraperitoneal injection of CTL as a complementary therapy, the results ascites dissipated, tumor gradually disappear and improve