Clinicopathological Features of Low-Grade Appendiceal Mucinous Neoplasms Confined to the Appendix.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2021-07-08 eCollection Date: 2021-01-01 DOI:10.3389/fonc.2021.696846
Yiyan Lu, Fang Li, Ruiqing Ma, Lan Fang, Changhai Qi
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引用次数: 4

Abstract

Objective: To investigate the clinicopathological features and follow-up of low-grade appendiceal mucinous neoplasms (LAMNs) confined to the appendix.

Methods: The clinicopathological features, pathological primary tumor (pT) staging and follow-up of 22 patients with LAMNs confined to the appendix were analyzed retrospectively.

Results: Of 22 patients with LAMNs, 14 were pTis (eight pTism and six pTisf), six were pT3, and two were pT4a. The appendiceal diameter was significantly larger for pTisf than for pTism. The interval between first symptoms and surgery was longer for pTisf than for pTism, but not significantly different. No significant differences were found between the pT stages and appendiceal diameter or in the interval between the first symptoms and surgery. Pathomorphologically, the epithelial structures were mainly flat (100%), undulating or scalloped (82%); a few showed filiform villous hyperplasia (46%), and seven (32%) had serrated lesions in the background. Diverticula may be associated with LAMNs, and the location of acellular mucin caused by diverticula affected the pT stage of the LAMNs. The immunohistochemistry information showed the same pattern with cytokeratin 7 (CK7) negative, cytokeratin 20 (CK20) positive and caudal type homeobox 2 (CDX-2) positive. No lymph node metastasis was found. The lack of treatment guidelines for LAMNs confined to the appendix and different acceptances of patients of preventive intervention led to varied clinical treatments. However, we found no short-term benefits of prophylactic extended resection or hyperthermic intraperitoneal chemotherapy.

Conclusion: LAMNs confined to the appendix are rare and must be differentiated from serrated lesions and diverticula. LAMNs with different pT stages have inert biological behavior. Determining the long-term effects of preventive treatment on survival and recurrence requires more data and a longer follow-up.

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局限于阑尾的低级别阑尾黏液性肿瘤的临床病理特征。
目的:探讨局限于阑尾的低级别阑尾黏液性肿瘤的临床病理特点及随访。方法:回顾性分析22例局限于阑尾的LAMNs的临床病理特点、病理原发肿瘤分期及随访情况。结果:22例LAMNs患者中,14例为pTis(8例为pTism, 6例为pTisf), 6例为pT3, 2例为pT4a。pTisf的阑尾直径明显大于pTism。pTisf的首次症状和手术之间的间隔时间比pTism的更长,但没有显著差异。在pT分期和阑尾直径之间或在首次症状和手术之间的时间间隔中没有发现显著差异。病理形态学上,上皮结构以扁平(100%)、波状或扇形(82%)为主;少数表现为丝状绒毛增生(46%),7例(32%)背景呈锯齿状病变。憩室可能与LAMNs有关,憩室引起的脱细胞粘蛋白的位置影响LAMNs的pT期。免疫组化结果显示细胞角蛋白7 (CK7)阴性,细胞角蛋白20 (CK20)阳性,尾型同源盒2 (CDX-2)阳性。未发现淋巴结转移。由于局限于阑尾的lamn缺乏治疗指南以及患者对预防干预的接受程度不同,导致临床治疗方法不一。然而,我们没有发现预防性延长切除或腹腔内高温化疗的短期益处。结论:局限于阑尾的lamn是罕见的,必须与锯齿状病变和憩室相鉴别。具有不同pT阶段的LAMNs具有惰性生物行为。确定预防性治疗对生存和复发的长期影响需要更多的数据和更长的随访。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
期刊介绍: ACS Applied Electronic Materials is an interdisciplinary journal publishing original research covering all aspects of electronic materials. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials science, engineering, optics, physics, and chemistry into important applications of electronic materials. Sample research topics that span the journal's scope are inorganic, organic, ionic and polymeric materials with properties that include conducting, semiconducting, superconducting, insulating, dielectric, magnetic, optoelectronic, piezoelectric, ferroelectric and thermoelectric. Indexed/​Abstracted: Web of Science SCIE Scopus CAS INSPEC Portico
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