原发性阑尾肿瘤发生腹膜转移的危险因素分析  

Risk factors of peritoneal metastasis in primary appendiceal tumor

作　　者：黄旭明 刘炫辉 黄凌玉 蔡泽荣[1] 陈钰锋[1] 吴小剑[1] Huang Xuming;Liu Xuanhui;Huang Lingyu;Cai Zerong;Chen Yufeng;Wu Xiaojian(Department of Coloretcal Surgery,the Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院结直肠外科,广州510655

出　　处：《中华肿瘤杂志》2021年第7期806-809,共4页Chinese Journal of Oncology

基　　金：国家自然科学基金(81972212);广东省自然科学基金(2019A1515010063)。

摘　　要：目的探讨原发性阑尾肿瘤发生腹膜转移的危险因素。方法回顾性分析2012年12月至2019年1月于中山大学附属第六医院就诊的71例原发性阑尾肿瘤患者的临床病理资料,采用多因素logistic回归分析原发性阑尾肿瘤腹膜转移的危险因素。结果71例患者中,腹膜转移(腹膜转移组)33例,无腹膜转移(无腹膜转移组)38例。腹膜转移组患者术前癌胚抗原(CEA)升高21例,无腹膜转移组3例,差异有统计学意义(P<0.001);腹膜转移组术前糖类抗原199升高16例,无腹膜转移组2例,差异有统计学意义(P<0.001);腹膜转移组病理类型为腺癌(包括黏液腺癌和结肠型腺癌)30例,无腹膜转移组12例,差异有统计学意义(P<0.001);腹膜转移组淋巴结转移12例,无腹膜转移组3例,差异有统计学意义(P=0.003)。术前CEA升高、病理类型为腺癌为阑尾肿瘤发生腹膜转移的独立危险因素(均P<0.05)。结论原发性阑尾肿瘤发生腹膜转移的概率高且预后差,术前CEA升高、病理类型为腺癌的阑尾肿瘤更有可能发生腹膜转移。Objective To investigate the risk factors of peritoneal metastasis in primary appendiceal tumor.Methods The clinic data of 71 patients with primary appendiceal tumor admitted in the Sixth Affiliated Hospital of Sun Yat-sen University between Dec 2012 and Jan 2019 were enrolled retrospectively.Multivariate logistic regression analysis were carried out to evaluate the risk factors of appendiceal tumor with peritoneal metastasis.Results Of the 71 patients,33 were peritoneal metastasis(peritoneal metastasis group)and 38 were non-peritoneal metastasis(no peritoneal metastasis group).Twenty-one patients in the peritoneal metastasis group had increased preoperative cancer embryo antigen(CEA),while 3 cases in the non-peritoneal metastasis group,with statistically significant difference(P<0.001).Sixteen cases in peritoneal metastasis group had increased preoperative carbohydrate antigen 199,while only 2 cases in the non-peritoneal metastasis group,the difference was statistically significant(P<0.001).The pathological type of 30 cases in the peritoneal metastasis group was adenocarcinoma(including mucus adenocarcinoma and colon adenocarcinoma),while 12 cases of adenocarcinoma in the non-peritoneal metastasis group,with statistically significant difference(P<0.001).Twelve cases in the peritoneal metastasis group had lymph node metastasis,while 3 cases in the non-peritoneal metastasis group,the difference is statistically significant(P=0.003).Preoperative CEA elevation and pathological type is adenocarinoma were independent risk factors for peritoneal metastasis of appendiceal cancer(P<0.05).Conclusions The propensity of peritoneal metastasis in primary appendiceal tumor is high and the outcome is poor.Patients with increased preoperative CEA,adenocarcinoma histopathology are more inclined to have peritoneal metastasis.

关 键 词：原发性阑尾肿瘤 阑尾腺癌 腹膜转移 危险因素 

分 类 号：R735.36[医药卫生—肿瘤]