阑尾神经内分泌肿瘤的临床体会

C. Ozcelik, S. Turanli, N. Bozdogan, C. Dibekoğlu
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引用次数: 3

摘要

目的分析阑尾切除术标本中阑尾神经内分泌肿瘤的发病情况,探讨其流行病学、组织病理学特点、治疗方法及临床病程。材料和方法回顾性分析2004年至2013年在安卡拉肿瘤教育和研究医院接受阑尾切除术的975例患者。结果975例患者中有9例(0.9%)检出神经内分泌肿瘤。8例患者因预先诊断为急性阑尾炎而行阑尾切除术诊断为神经内分泌肿瘤,1例患者因不同原因在阑尾手术过程中发现可疑肿块。其中8名患者的肿瘤位于阑尾顶端,1名患者的肿瘤位于阑尾底部。77.8%的患者肿瘤大小等于或小于1cm, 22.2%的患者肿瘤大小为1 - 2cm。肿瘤侵袭固有肌层者4例,浆膜层者3例,阑尾深层系膜者2例。患者的随访时间中位数为78个月。在对结肠癌手术患者的随访中,异时性结肠癌出现。该患者因病情进展而死亡。其他病人仍然没有患病。结论阑尾切除术后对神经内分泌肿瘤的诊断往往是偶然的。肿瘤大小是确定疾病范围和手术方法选择的重要依据。
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Clinical experience in appendiceal neuroendocrine neoplasms
Aim of the study To analyse the incidence of appendiceal neuroendocrine neoplasms in appendectomy specimens and establish the epidemiological and histopathological features, treatment, and clinical course. Material and methods Between 2004 and 2013, 975 patients who underwent appendectomy in Ankara Oncology Education and Research Hospital were retrospectively analysed. Results Neuroendocrine neoplasm was detected in the nine of 975 (0.9%) patients. Neuroendocrine neoplasms were diagnosed in eight patients by appendectomy, which was performed because of the prediagnosis of acute appendicitis, and in one patient by the suspicious mass detection during surgical procedures that were done in the appendix for a different reason. Eight of the patients’ tumours were in the tip of the appendix, and one of the patients’ tumours was at the base of appendix. Tumour size in 77.8% of patients was equal or less than 1 cm, in 22.2% patients it was 1–2 cm. There was tumour invasion in the muscularis propria layer in four patients, in the serosa layer in three patients, and in the deep mesoappendix in two patients. Patients were followed for a median of 78 months. In the follow-up of patients who were operated because of colon cancer, metachronous colon tumour evolved. This patient died due to progressive disease. Other patients are still disease-free. Conclusions The diagnosis of neuroendocrine neoplasm is often incidentally done after appendectomy. Tumour size is important in determining the extent of disease and in the selection of the surgical method during operation.
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