阑尾黏液性肿瘤的超声表现及临床特征  

Ultrasonographic manifestations and clinical characteristics of appendiceal mucinous tumors

作　　者：齐芳 范丽平 康亚宁 屈文涛 崔晓媛 苏洁 QI Fang;FAN Liping;KANG Yaning;QU Wentao;CUI Xiaoyuan;SU Jie(Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710000,China)

机构地区：[1]西安市中医医院,陕西西安710000

出　　处：《临床医学研究与实践》2023年第3期94-97,共4页Clinical Research and Practice

摘　　要：目的分析阑尾黏液性肿瘤(AMT)的超声表现及临床特征。方法纳入2018年9月至2020年12月西安市中医医院收治的86例AMT患者,其中阑尾黏液性囊腺瘤(AMCA)22例,阑尾黏液性腺癌(AMAC)24例,低级别黏液性肿瘤(LAMN)40例。以术后病理诊断为金标准,分析超声对不同类型AMT的诊断准确率。比较AMCA、AMAC、LAMN患者的临床特征。结果86例AMT患者中,44例患者的超声诊断结果与病理诊断结果相符合,诊断准确率为51.16%;42例误诊,误诊率为48.84%,其中AMCA患者误诊6例(误诊为阑尾炎3例,系膜囊肿1例,阑尾脓肿2例)、AMAC患者误诊14例(误诊为阑尾炎6例,阑尾脓肿4例,卵巢肿瘤2例,系膜囊肿1例,AMCA 1例)、LAMN患者误诊22例(误诊为阑尾炎10例,阑尾脓肿6例,卵巢肿瘤1例,系膜囊肿3例,AMCA 2例)。超声对AMCA的诊断准确率明显高于AMAC和LAMN,差异具有统计学意义(P<0.05)。AMT患者的临床主诉以右下腹疼痛为主,44.19%的患者累及腹腔脏器,肿瘤标志物以CEA和CA125阳性率最高。AMCA患者累及腹腔脏器的发生率、CEA阳性率均明显低于AMAC、LAMN患者,差异具有统计学意义(P<0.05);不同类型AMT患者的年龄、性别、临床主诉及WBC、PLT、Hb异常率、CA125、AFP、CA242、CA199阳性率比较,差异均无统计学意义(P>0.05)。结论不同类型AMT患者的超声特征具有一定差异,且与AMCA相比,LAMN和AMAC的超声特征更为复杂多样,且CEA阳性率和腹腔远处转移率更高。Objective To analyze the ultrasonic manifestations and clinical characteristics of appendiceal mucinous tumors(AMT).Methods A total of 86 patients with AMT admitted in Xi’an Hospital of Traditional Chinese Medicine from September 2018 to December 2020 were included,including 22 cases of appendiceal mucinous cystic adenocarcinoma(AMCA),24 cases of appendiceal mucinous adnocarcinoma(AMAC)and 40 cases of low-grade appendiceal mucinous neoplasm(LAMN).The diagnostic accuracy of ultrasound for different types of AMT was analyzed with postoperative pathological diagnosis as the gold standard.The clinical characteristics of AMCA,AMAC and LAMN patients were compared.Results Among the 86 patients with AMT,the ultrasound diagnostic results of 44 patients were consistent with the pathological diagnostic results,and the diagnostic accuracy was 51.16%;there were 42 cases of misdiagnosis,and the misdiagnosis rate of 48.84%,including 6 cases of AMCA patients were misdiagnosed(3 cases of appendicitis,1 case of mesangial cyst,2 cases of appendix abscess),14 cases of AMAC patients were misdiagnosed(6 cases of appendicitis,4cases of appendix abscess,2 cases of ovarian tumor,1 case of mesangial cyst,1 case of AMCA),22 cases of LAMN patients were misdiagnosed(10 cases of appendicitis,6 cases of appendix abscess,1 case of ovarian tumor,3 cases of mesangial cyst,2 cases of AMCA).The diagnostic accuracy of ultrasound for AMCA was significantly higher than that of AMAC and LAMN,and the difference was statistically significant(P<0.05).The main clinical complaints of AMT patients were right lower abdominal pain,44.19%of patients involved abdominal organs,and the positive rates of CEA and CA125were the highest.The incidence of abdominal organ involvement and CEA positive rate in AMCA patients were significantly lower than those in AMAC and LAMN patients,and the differences were statistically significant(P<0.05);there were no significant differences in age,gender,clinical complaints and abnormal rates of WBC,PLT,Hb,positive rates of CA125,A

关 键 词：阑尾黏液性肿瘤 阑尾黏液性囊腺瘤 阑尾黏液性腺癌 低级别黏液性肿瘤 超声检查 肿瘤标志物 诊断准确率 

分 类 号：R735.3[医药卫生—肿瘤]