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目的探讨阑尾类癌的生物学特性、临床诊断和手术治疗经验,提高首次手术治愈率。方法对1985—2004年我们收治的21例阑尾类癌患者的临床及病理资料进行回顾性分析。结果21例中无1例术前诊断,均为术中偶然发现或术后病理确诊。采用单纯性阑尾切除术16例,回盲部切除术2例,右半结肠切除2例,姑息性手术1例。肿瘤直径<1 cm 15例,1~2 cm 3例,>2 cm 3例。14例肿瘤浸润深度限于黏膜下或肌层,3例侵及浆膜,4例浸润至阑尾系膜,其中3例患者肿瘤>2 cm伴局部淋巴结转移。获随访的16例患者中,15例无复发和远处转移,1例死亡。结论阑尾类癌少见,多表现为阑尾炎症状,难以做出术前诊断。应根据肿瘤大小、部位及浸润深度决定术式及切除范围。
Objective To investigate the biological characteristics of appendix carcinoid, clinical diagnosis and surgical treatment experience, improve the rate of first-time surgery. Methods The clinical and pathological data of 21 cases of appendix carcinoid we treated from 1985 to 2004 were analyzed retrospectively. Results No one of 21 cases had preoperative diagnosis, all of which were found by accident or pathologically confirmed after surgery. Simple appendectomy in 16 cases, ileocecal resection in 2 cases, right colon resection in 2 cases, palliative surgery in 1 case. Tumor diameter <1 cm in 15 cases, 1 ~ 2 cm in 3 cases,> 2 cm in 3 cases. In 14 cases, the depth of tumor infiltration was limited to the submucosa or myometrium, 3 cases invaded the serosa, and 4 cases infiltrated into the appendix mesangial. Among them, 3 cases had> 2 cm tumor with local lymph node metastasis. Among the 16 patients who were followed up, 15 had no recurrence and distant metastasis and 1 died. Conclusion Appendiceal carcinoid rare, multi-performance appendicitis symptoms, it is difficult to make a preoperative diagnosis. Should be based on tumor size, location and depth of invasion to determine the surgical approach and resection range.