阑尾黏液性肿瘤的诊断及治疗进展  

Progress on Diagnosis and Treatment of Appendiceal Mucinous Tumor

作　　者：安鲁彪 许洪斌[1] 夏奥 史冠军 王冰 卢一艳[1] AN Lu-biao;XU Hong-bin;XIA Ao;SHI Guan-jun;WANG Bing;LU Yi-yan(Aerospace Central Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院,北京100049 [2]北京大学航天中心医院黏液瘤科,北京市海淀区100049

出　　处：《肿瘤学杂志》2021年第4期310-315,共6页Journal of Chinese Oncology

摘　　要：阑尾黏液性肿瘤(appendiceal mucinous neoplasm,AMN)临床罕见,对于局限于阑尾管腔的AMN临床表现倾向良性,手术完整切除后预后良好。如处理不当发生破裂或肿瘤进展发生腹膜假黏液瘤(pesudomyxomaperitonei,PMP),临床重视不够未及时处理将会导致预后不良的结局且严重影响生活质量。术前彩超及CT检查对诊断AMN有一定的临床价值,但总体术前诊断较为局限,多数病例为术中意外发现,约40%的病例手术后才能确诊。对于AMN,外科手术完整切除肿瘤避免囊壁破裂是基本处理原则,可以最大限度的降低未来复发风险,延长患者远期生存。术后应密切随访警惕PMP发生及合并异时的结直肠肿瘤可能。如术中一旦发现肿瘤破裂必须充分探查腹腔评价并记录腹腔内肿瘤负荷情况,对于发生PMP的患者应及时转往腹膜肿瘤治疗经验丰富的中心进行治疗,以免错过最佳的根治手术治疗时机。Appendiceal mucinous neoplasm(AMN) is a rare clinical condition. If the tumor is confined to the appendix lumen,AMN tends to be benign with a favorable prognosis after complete resection. However,once pesudomyxomaperitonei(PMP) is formed after tumor rupture or progression,the prognosis and the quality of life would become poor. Preoperative Doppler ultrasound and CT examinations can provides preliminary diagnosis of AMN,but the value of preoperative diagnosis is relatively limited,and about 40% of cases only can be confirmed after surgery. The complete resection avoiding capsular wall rupture is the basic management principle for AMN,which can minimize the risk of future recurrence and prolong the long-term survival of the patients. The patients should be closely followed-up postoperatively to alert the possibility of PMP and concurrent colorectal tumors. If a tumor rupture is found during the operation,the abdominal cavity should be fully explored and the tumor load in the abdominal cavity should be recorded.Patients with PMP should be transferred to an experienced center for peritoneal tumor treatment timely to get the best opportunity for cure.

关 键 词：阑尾黏液性肿瘤 腹膜假黏液瘤 阑尾切除 腹腔播散 

分 类 号：R735.36[医药卫生—肿瘤]