TNM不同分期在阑尾神经内分泌肿瘤患者预后评估中的价值  

The evaluation of different stages of TNM in prognosis of appendiceal neuroendocrine tumors

作　　者：肖应泽[1] 班东杰[1] 魏建明[2] 张升宁[3] 

机构地区：[1]天津市公安医院普通外科,300020 [2]天津医科大学总医院普通外科 [3]昆明市第一人民医院普通外科

出　　处：《天津医药》2017年第10期1080-1082,共3页Tianjin Medical Journal

摘　　要：目的探讨TNM不同分期对阑尾神经内分泌肿瘤(NETs)患者预后的影响。方法回顾性分析40例阑尾神经内分泌肿瘤临床病理特点和手术情况。根据2006年欧洲神经内分泌肿瘤协会(ENETS)TNM及2010年美国癌症联合委员会(AJCC)TNM分期标准分别对其预后进行评估并得到综合TNM分期,应用Kaplan-Miere生存曲线分析比较TNM不同分期患者生存差异。结果 40例阑尾NETs中术前无1例确诊为阑尾NETs,术前诊断为急性阑尾炎21例,慢性阑尾炎16例,因管腔明显增粗怀疑阑尾肿瘤3例。所有患者术前均无腹泻、腹痛、颜面潮红、哮喘样发作等类癌综合征的表现;均行阑尾切除术,术后经病理确诊为阑尾NETs。40例阑尾神经内分泌肿瘤患者中Ⅰ期15例(37.5%)、ⅡA期10例(25%)、ⅢA期2例(5%)、ⅢB期13例(32.5%),无Ⅳ期病例;各期患者中位生存时间分别为27、22、21及18个月,但累积生存率差异无统计学意义(χ~2=0.898 8,P>0.05)。结论阑尾神经内分泌肿瘤临床表现无特异性,确诊需依据病理学及免疫组织化学检查,TNM不同分期与患者预后生存率无明确关联。Objective To investigate the prognostic value of different stages of TNM in patients with appendicealneuroendocrine tumors(NETs). Methods The clinical data of 40 cases of NETs were analyzed, and follow-up data werestaged by the ENETS and AJCC TNM staging system. Kaplan-Miere survival curves were used to compare survivaldifferences in patients with different stages of TNM. Results Of the 40 patients, no one was diagnosed as appendicealNETs before surgery. Twenty-one patients were diagnosed as acute appendicitis, 16 were diagnosed as chronic appendicitisand 3 were suspected as appendiceal tumors due to thickening of the lumen before surgery. No clinical manifestations werefound in 40 patients before surgery including diarrhea, abdominal pain, facial flushing, asthma-like seizures and othercarcinoid syndrome performance. All patients underwent appendectomy, and appendix NETs were diagnosed by pathologyafter surgery. In 40 appendical NETs patients, 15 cases were classified as stage Ⅰ(37.5%), 10 cases were classified as stageⅡA(25%), 2 cases were classified as stage ⅢA(5%), 13 cases were classified at stage ⅢB(32.5%), and no patients wereclassified as stage Ⅳ. The median survival times(months) were 27, 22, 21 and 18 for patients with different stages, and therewere no significant differences in survival times between four stages(χ~2=0.898 8,P>0.05). Conclusion The clinicalfeatures of appendical NETs are nonspecific. The diagnosis of appendical NETs is based on pathological examination andimmunohistochemistry. There are no correlation between different TNM stages and prognosis of patients.

关 键 词：神经内分泌瘤 阑尾 肿瘤分期 预后 Kaplan-Meier评估 TNM分期 

分 类 号：R656.8[医药卫生—外科学]