Peritoneal mesothelioma check what should be done?

1. Blood tests of patients with peritoneal mesothelioma may have thrombocytosis low blood sugar increased fibrin degradation products and high immunoglobulin hyperlipidemia in patients with peritoneal mesothelioma, about 25% of patients so that the part of the CA125 elevated Duan mesothelial cell-derived tumors have the ability to secrete CA125 at the same time if the patient has peritoneal mesothelioma, intrahepatic metastasis of liver with chronic liver disease caused by the scavenging capacity of CA125 decline in the serum CA125 level may be significantly increased due to increased CA125 is also more common in ovarian cancer can be found in pancreatic cancer Therefore, gastric cancer and breast cancer serum CA125 determination in the differential diagnosis of peritoneal mesothelioma is not
2. Ascites ascites examination of peritoneal mesothelioma can bloody or yellow exudate cells due to mesothelioma, an active function of the secretion of hyaluronic acid in the hyaluronic acid concentration in serosal effusions of up to 0.2 ~ 0.8g / L (turbidity test) although the infection and heart failure caused by metastatic tumors in serous effusion may also be increased but the hyaluronic acid concentration is greater than 0.8g / L were seen only in malignant mesothelioma, hyaluronic acid content, therefore ascites Determination of the diagnosis of peritoneal mesothelioma, mesothelioma, an organization of reference value due to the lack of carcinoembryonic antigen (CEA), such as CEA in ascites were higher than 10 ~ 15μg / L right to exclude the diagnosis of malignant mesothelioma of some significance also was found : mesothelioma patients with ascites increased levels of acid mucopolysaccharide mesothelioma cells with anti-serum can be detected in serous exudate ascites addition, the corresponding antigen human chorionic gonadotropin (HCG) increased levels of plasma HCG levels normal help to distinguish benign and malignant peritoneal mesothelioma in the collagen level of ascites can help to distinguish between the presence of lesions of mesothelioma or metastatic adenocarcinoma
Ascites cytology has certain clinical value reported in the literature at home and abroad ascites in patients with peritoneal mesothelioma often can not find the typical mesothelioma cells, ascites, if found in a large number of special-shaped or atypical mesothelial cells or tumor cells can be Analysis of measured nuclear area ratio of cytoplasmic area and nuclear plasma parameters, such as combination of electron microscopy and immunohistochemistry with the proliferation of check to mesothelial cells and metastatic adenocarcinoma, sarcoma, and other identification
1. Gastrointestinal tract gastrointestinal tract contrast imaging have the following performance:
(1) The shift to change the compression bowels twisted bowel loop shape is not the whole distance widened
(2) The abnormal distribution bowels crowded around the tumor margin of the distribution of weeks
(3) If the intestine caused by tumor compression severe stenosis can be expressed as incomplete intestinal obstruction
(4) late aggregation adhesion can occur bowels regular and intact mucosal folds but the performance of both the above-mentioned non-specific prompts the disease can only be indirectly
2. Abdominal ultrasound ascites due to peritoneal mesothelioma often accompanied by production of ascites in the ultrasound observation of peritoneal provide a good acoustic conditions for a long time can clearly observe the ascites into the peritoneal site of its new size and shape echoes the common ultrasonic peritoneal mesothelioma like the diagram has the following characteristics:
(1), irregular thickening of part of the peritoneum was much more substantial part of the mass change in shape was irregular lobulated
(2) may be associated with ascites after retroperitoneal lymph nodes or other organs of the transfer of audio-visual
(3) accompanied by thickening of greater omentum and mesentery of the bowel caused by the pushing pressure of incomplete intestinal obstruction, and changes in intestinal adhesion
(4) line of color Doppler ultrasound lumps around and see the rich blood flow within the ultrasound examination the diagnosis of peritoneal mesothelioma have a certain value of ultrasound-guided biopsy of the pathological diagnosis of the exact available
3.CT scan CT scan diagnosis of peritoneal mesothelioma peritoneal mesothelioma must help ascites is the most common CT manifestations; Early CT showed peritoneal lesions more difficult; as a wide range of peritoneal adhesions greater omentum and mesentery can be seen when the CT under the wide range of irregular thickening of the omentum of the peritoneal adhesion formation involved Pie mesenteric abdominal mass density increased adhesion formation, or wrinkled paper flowers star-shaped mass in the performance characteristics of CT is not easy, but the gastrointestinal tract and ovarian cancer and peritoneal metastasis identification of chronic infections CT periodically review the progress and efficacy of the lesions observed are very useful
Number of other instruments such as imaging studies such as celiac artery angiography MRI can be used for the diagnosis of peritoneal mesothelioma, but because of their trauma or expensive than commonly used in clinical
4. Laparoscopy Laparoscopy is a simple and effective means of diagnosis of malignant peritoneal mesothelioma microscope parietal and visceral peritoneum omentum diffuse distribution of hepatic tumor nodules plaque fibrous capsule (Glisson's capsule) There may also have nodules, but the performance of liver parenchyma without invasion; endoscopic intra-abdominal non-metastatic liver cancer or other pelvic organs, microscopic evidence of tumor can be parietal and visceral peritoneum and omentum lesions and lesions at relatively normal organization at the junction of multiple biopsy forceps with a larger organization can be satisfactory for the pathological examination Laparoscopy can exclude other organs within the abdominal or pelvic tumor and disease microscopy without any complications, but a large number of intra-abdominal ascites broad and organs within the lesion marked by laparoscopic examination of adhesion subject to certain restrictions
B-ultrasonography and CT examination can be found in a thin sheet of images and ascites ascites tumor exudate can also be as bloody ascites in hyaluronic acid, such as increased to 120ug/ml helpful in the diagnosis of ascites to find new biological mesothelioma cells with a diagnosis of ascites can also be the middle of the skin cell chromosome analysis assist in diagnosis of laparoscopies, visible peritoneal surface nodules and plaques covered with pathological examination confirm the diagnosis of biopsy