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目的 探讨阑尾类癌的生物学特性、诊断和外科治疗经验。方法 回顾性总结自196 7～ 1997年收治的 2 1例阑尾类癌患者的临床和病理资料。结果 本组 2 1例患者中有 12例(5 7% )的症状和体征提示为急性阑尾炎。 9例患者 (43 % )为偶然发现。肿瘤直径小于 1cm有 16例 ,1～ 2cm 3例 ,大于 2cm 2例。 15例肿瘤浸润深度限于粘膜下或肌层 ,4例侵及浆膜。有 2例患者显示肿瘤浸润至阑尾系膜 ,1例患者肿瘤大于 2cm伴局部淋巴结转移。除 1例肿瘤直径大于 2cm且伴阑尾系膜淋巴结阳性者再次行右半结肠切除术外 ,其余 2 0例均仅行阑尾切除术。获随访的 19例患者中 ,所有患者均无复发和远处转移。结论 阑尾类癌少见且多无症状。小于 1cm的阑尾类癌仅作单纯性阑尾切除术即可。肿瘤大于 2cm的患者应行右半结肠切除术。
Objective To explore the biological characteristics, diagnosis and surgical treatment experience of appendiceal carcinoid. Methods The clinical and pathological data of 21 cases of appendiceal carcinoid patients admitted from 196 to 1997 were retrospectively reviewed. Results The symptoms and signs of 12 (57%) of the 21 patients in this group showed acute appendicitis. Nine patients (43%) were found by chance. The tumor diameter was less than 1cm in 16 cases, 1 to 2cm in 3 cases, and 2cm in 2 cases. The depth of invasion of 15 cases was limited to the submucosa or muscularis and 4 cases invaded the serosa. Two patients showed infiltration of the tumor to the mesentery of the appendix, and one patient had tumors larger than 2 cm with regional lymph node metastases. Except for one patient whose tumor diameter was more than 2cm and with mesenteric lymph node positive, he underwent right hemicolectomy. The rest of 20 patients only underwent appendectomy. Of the 19 patients who were followed up, all patients did not have recurrence or distant metastases. Conclusion The appendix carcinoid is rare and often asymptomatic. The appendix carcinoid of less than 1cm can only be used for simple appendectomy. Patients with tumors larger than 2 cm should undergo right hemicolectomy.