阑尾低级别黏液性肿瘤临床诊治的研究进展

目的 总结阑尾低级别黏液性肿瘤的临床诊治的研究进展。方法 在中国知网、万方数据和PubMed、Web of Science等数据库,以“阑尾低级别黏液性肿瘤” “阑尾黏液性肿瘤” “腹膜假性黏液瘤”和“low-grade appendiceal mucinous neoplasm” “appendiceal mucinous neoplasm” “pseudomyxoma peritonei”为关键词,检索2018年8月以前发表的有关阑尾低级别黏液性肿瘤临床诊治的文献,进行归纳总结。结果 阑尾低级别黏液性肿瘤是阑尾上皮性肿瘤的主要病理类型之一,主要特点是不同原因引起阑尾管腔的慢性炎症导致管腔的狭窄,黏液物质不断聚集,在腔内压力不断增加的基础下,黏液侵及阑尾壁内或突破至壁外。阑尾低级别黏液性肿瘤的病理诊断标准更加形象具体,有助于诊断、病理分期及评估预后;对该肿瘤的临床表现、体征及影像学的认识更加透彻,有助于疾病的早期发现和鉴别诊断;其治疗方式在切除范围及黏液清除程度上有了基本统一的治疗方案。结论 阑尾低级别黏液性肿瘤在临床表现上无特异性,CT及超声的诊断率在逐步提高,该肿瘤具有低度恶性,要做到完整切除肿瘤,即使扩大切除范围也要避免瘤体破裂的风险。

Research progress on the diagnosis and treatment of low-grade appendiceal mucinous neoplasm

Objective To investigate the research progress on the diagnosis and treatment of low-grade appendiceal mucinous neoplasm.Methods The keywords of “low-grade appendiceal mucinous neoplasm”, “appendiceal mucinous neoplasm” and “pseudomyxoma peritonei” were used to search the related literatures in PubMed, Web of Science,CNKI, and Wanfang Date before August 2018 and to summarize the clinical diagnosis, treatment, and research of low-grade appendiceal mucinous neoplasm.Results Low-grade appendiceal mucinous neoplasm was one of the main pathological types of epithelial appendiceal tumor, which was characterized by the stenosis of the appendiceal lumen caused by chronic inflammation of the appendiceal lumen caused by different reasons. Mucinous substances were constantly accumulating, and on the basis of the increasing pressure in the lumen, the mucus invaded the appendix wall or broke through the wall. The pathological diagnostic criteria of a low-grade appendiceal mucinous neoplasm are more specific and helpful for diagnosis, pathological stage, and prognosis evaluation. The clinical manifestations, signs, and imaging of the tumor are better understood, which is conducive to the early detection and differential diagnosis of the disease; Its treatment method has the basic unified treatment plan in the excision scope and the mucus removal degree.Conclusions The non-specificity of clinical manifestations, the diagnostic rate of CT and ultrasound for low-grade appendiceal mucinous neoplasm is gradually increasing. This tumor has a low degree of malignancy. To complete the resection of the tumor, the risk of tumor rupture should be avoided even if the resection scope is expanded.