原发性阑尾肿瘤的临床特征、治疗及预后影响因素分析  

Clinical features,treatment and prognostic factors of primary appendiceal tumor

作　　者：罗欢 李建新 苟豪贤 杨庆强 LUO Huan;LI Jianxin;GOU Haoxian;YANG Qingqiang(Department of Gastrointestinal Surgery,Affiliated Hospital of Southwest Medical University,Luzhou,Sihcuan 646000,P.R.China;Sichuan Key Laboratory of Nuclear Medicine and Molecular Imaging,Affiliated Hospital of Southwest Medical University,Luzhou,Sihcuan 646000,P.R.China)

机构地区：[1]西南医科大学附属医院胃肠外科,四川泸州646000 [2]西南医科大学附属医院核医学与分子影像四川省重点实验室,四川泸州646000

出　　处：《中国普外基础与临床杂志》2023年第6期721-727,共7页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨原发性阑尾肿瘤的临床特点、治疗方式以及预后影响因素。方法回顾性收集2013年1月至2022年11月期间在西南医科大学附属医院诊治的符合纳入与排除标准的82例原发性阑尾肿瘤患者的临床病理学资料,总结患者的临床病理学特征。对未合并其他恶性肿瘤的患者进一步采用log-rank和Cox比例风险回归模型进行单因素和多因素生存分析。结果82例原发性阑尾肿瘤患者中,合并其他恶性肿瘤者9例(11.0%);以低级别黏液性肿瘤最为常见(51.2%,42/82),合并阑尾炎25例、肠梗阻12例;常见的临床表现有腹痛、排便习惯改变、腹胀、呕吐、恶心等。未合并其他恶性肿瘤的患者中,69例患者获访,中位随访时间为32个月(4~106个月),其中18例死亡;患者的1、2、3和5年累积生存率分别为91.1%、87.5%、80.5%和60.7%。多因素Cox比例风险回归分析结果显示,血小板/淋巴细胞比(P=0.004)、贫血(P=0.015)、肿瘤转移(P=0.007)和糖尿病(P=0.011)是影响患者预后的因素,血小板/淋巴细胞比>190.1、发生贫血、发生肿瘤转移及合并糖尿病的患者预后较差。结论原发性阑尾肿瘤以低级别黏液性肿瘤为主要病理类型,缺乏特征性的临床表现,以腹痛、排便习惯改变为主要表现,可并发阑尾炎、肠梗阻,治疗方式尚无统一标准。对于具有预后危险因素特征的患者,包括血小板/淋巴细胞比>190.1、贫血、肿瘤转移和糖尿病,需要进一步监测和干预。Objective To explore the clinical features,treatment methods and prognostic factors of primary appendiceal tumors.Methods The clinicopathologic data of 82 patients with primary appendiceal tumor who met the inclusion and exclusion criteria and were treated in the Affiliated Hospital of Southwest Medical University from January2013 to November 2022 were retrospectively collected,and the clinicopathologic characteristics of the patients were summarized.Log-rank and Cox proportional hazard regression models were further used for univariate and multivariate survival analysis for patients without other malignant tumors.Results Among the 82 patients with primary appendiceal tumor,9 cases(11.0%)were complicated with other malignant tumors.Low-grade mucinous tumors were the most common(51.2%,42/82),25 cases were complicated with appendicitis and 12 cases were complicated with intestinal obstruction.Common clinical manifestations included abdominal pain,changes in bowel habits,abdominal distension,vomiting,nausea,etc.Among the patients without other malignancies,69 patients were followed up for a median of 32 months(4–106 months),18 of whom died.The 1-year,2-year,3-year and 5-year cumulative survival rates were 91.1%,87.5%,80.5%and 60.7%,respectively.Multivariate Cox proportional hazard regression analysis showed that platelet-to-lymphocyte ratio(P=0.004),anemia(P=0.015),tumor metastasis(P=0.007)and diabetes mellitus(P=0.011)were prognostic factors.Among them,patients with platelet-to-lymphocyte ratio 190.1,anemia,tumor metastasis and diabetes mellitus had poor prognosis.Conclusions The main pathological type of primary appendiceal tumors is low grade mucinous tumors.It lacks characteristic clinical manifestations,with abdominal pain and changes in bowel habits as the main manifestations,and can be accompanied by appendicitis and intestinal obstruction.There is no unified standard for treatment.For patients characterized by prognostic risk factors including platelet-to-lymphocyte ratio >190.1,anemia,tumor metastasis and

关 键 词：原发性阑尾肿瘤 临床特点 治疗方法 预后 

分 类 号：R735.36[医药卫生—肿瘤]