摘要
目的探讨11例阑尾原发性恶性肿瘤的临床特征、病理特点及治疗方式。方法回顾性分析2016年9月至2024年5月北京市房山区良乡医院诊治的11例阑尾原发性恶性肿瘤患者的临床及病理资料,分析患者临床特征、手术方式、病理特征、辅助治疗及预后生存情况。结果11例患者中男7例,女4例;平均年龄(54.36±16.72)岁。10例表现为右下腹疼痛,1例表现为腹痛腹胀;实验室检查显示8例白细胞计数升高,3例正常;10例患者行阑尾切除术,另1例因结肠癌行右半结肠根治术后偶然发现阑尾神经内分泌肿瘤。术后病理:8例为神经内分泌肿瘤[世界卫生组织(World Health Organization,WHO)分级:G1级7例,G2级1例;恶性肿瘤国际临床病理(tumor node metastasis,TNM):T1期],1例为杯状细胞腺癌(WHO:G1级;TNM:T1期),1例为高分化腺癌(WHO:G1级;TNM:T3期),1例为高分化黏液腺癌(WHO:G1级;TNM:T3期)。3例患者二次手术行右半结肠根治术,除1例高分化黏液腺癌患者发现1枚淋巴结有转移性癌外,其余均未发现淋巴结转移及神经或脉管侵犯。随访2~76个月,除1例结肠癌患者术后3个月死于肺栓塞外,其余病例均存活。结论阑尾原发性恶性肿瘤的发病率较低,缺乏特异性临床症状,术前超声及影像检查对其诊断价值有限,临床易误诊、漏诊,确诊需依据术后病理。
Objective To investigate the clinical features,pathological features and treatment of primary appendix malignant tumors.Methods The clinical and pathological data of 11 cases of primary appendix malignant tumors in Liangxiang Hospital of Beijing Fangshan District from September 2016 to May 2024 were retrospectively analyzed,the chinical characteristics,the surgical methods,pathological characteristics,adjuvant treatments and prognostic survival of the patients were analyed.Results Among the 11 patients,7 were male and 4 were female,the average age was(54.36±16.72)years old.10 patients had symptoms of right lower abdominal pain,and 1 patient had symptoms of abdominal pain and distension;the laboratory results showed elevated white blood cell counts in 8 patients and normal 3 patients;and 10 patients underwent appendectomy,the other patients had an incidental appendiceal neuroendocrine tumor after right half colon resection for the discovery of colon cancer.Postoperative pathological results showed that 8 patients were diagnosed with neuroendocrine tumors(World Health Organization[WHO]grading:7 patients were G1 grade,1 patient was G2 grade;tumor node metastasis[TNM]stage was T1 stage),1 patient was goblet cell adenocarcinoma(WHO:G1,TNM:T1),1 patient was highly differentiated adenocarcinoma(WHO:G1,TNM:T3),and 1 patient was highly differentiated mucinous adenocarcinoma(WHO:G1,TNM:T3).3 patients underwent right hemicolradical for secondary surgery,no lymph node metastasis and nerve or vascular invasion were found in any patient except 1 lymph node in a patient with mucinous adenocarcinoma.At a follow-up period of 2-76 months,all patients were alive except for one colon cancer patient who died of pulmonary embolism 3 months after surgery.Conclusion The incidence of primary appendiceal malignant tumor is low,its lack of specific clinical symptoms,and the diagnostic value of preoperative ultrasound and imaging examination is limited,it is easy for clinicians to misdiagnose,and its diagnosis depends on postoperative pathology.
作者
尹英爱
曹敏
秦桂萍
白苏日娜
齐淋喆
YIN Ying'ai;CAO Min;QIN Guiping;BAI Surina;QI Linzhe(Department of Pathology,Liangxiang Hospital of Beijing Fangshan District,Beijing,102401,China)
出处
《当代医学》
2025年第8期157-161,共5页
Contemporary Medicine
关键词
阑尾
原发性
恶性肿瘤
临床
病理
Appendix
Primarily
Malignant tumors
Clinical
Pathology
