阑尾肿瘤的诊治及预后分析  

Clinical diagnosis and treatment and prognosis of appendiceal neoplasms

作　　者：刘琦 折占飞[2] 王怀明[2] 马路[2] 鲁瑞 吴波[2] Liu Qi;She Zhanfei;Wang Huaiming;Ma Lu;Lu Rui;Wu Bo(Baotou Medical College,Baotou 014040,China;Department of General Surgery,Ordos Central Hospital,Ordos 017000,China)

机构地区：[1]包头医学院,内蒙古自治区014040 [2]鄂尔多斯市中心医院普外科,内蒙古自治区017000

出　　处：《中华普通外科杂志》2020年第4期296-299,共4页Chinese Journal of General Surgery

摘　　要：目的分析阑尾肿瘤的发病规律、临床特点及其预后,评价治疗方法,以提高阑尾肿瘤的诊断准确率和治疗效果。方法回顾性分析2005年1月至2019年7月在鄂尔多斯市中心医院6334例行阑尾切除手术中94例阑尾肿瘤患者的临床资料,记录其首发症状、临床表现、辅助检查、病理分型、手术方式及临床转归。采用Kaplan-Meier法计算患者的生存期.Log-rank检验进行单因素预后分析.结果阑尾肿瘤与阑尾手术占比达1.48%,94例患者中男45例,女49例,中位年龄59.5岁。随访80例,随访率85.1%,随访时间2-175个月。5、10年整体生存率为91.9%、88.9%。单因素分析结果显示,入院时外周血WBC>10.0×10^9/L(X^2=8.884,P=0.003)、出现淋巴结转移者(X^2=17.216,P=0.001)预后较差。阑尾腺癌相对于阑尾黏液性肿瘤的预后差(X^2=13.857,P=0.001)。结论阑尾肿瘤发病率极低;以慢性右下腹痛表现占较大比例;阑尾肿瘤的分类、入院时外周血WBC计数以及是否发生淋巴结转移影响其预后。Objective To analyze the pathogenesis and clinical characteristics of appendiceal neoplasms and its prognosis.Methods In recent 14 years,94 appendiceal neoplasms were found among 6334 patients undergoing appendectomy in a single center of Ordos Central Hospital.The initial symptoms,clinical features,auxiliary examinations,pathology,surgical methods,and clinical outcomes of 94 patients diagnosed with appendix tumors were recorded.Results Appendiceal neoplasms accounted for 1.48%for all undergoing appendectomy.Among these 94 cases,49 cases were female and 45 cases were male.The median age was 59.5 years.80 cases were followed up with a follow-up rate of 85.1%,and the follow-up period was 2-175 months.The 5-year overall survival rate was 91.9%and the 10-year overall survival rate was 88.9%.The results of univariate analysis of prognosis showed that the prognosis of patients with WBC count>10.0×10^9/L(X^2=8.884,P=0.003)and lymph node metastasis(X^2=17.216,P=0.001)was relatively poor.The prognosis of appendiceal adenocarcinoma is relatively poor compared with mucinous tumors(X^2=13.857,P=0.001).Conclusions The incidence of appendiceal neoplasms is very low;Chronic lower right abdominal pain accounted for a large proportion of the manifestations;Classification of appendiceal neoplasms,leukocyte count and lymph node metastasis predict the prognosis of patients with appendiceal neoplasms.

关 键 词：阑尾肿瘤 诊断 预后 

分 类 号：R735.36[医药卫生—肿瘤]