阑尾类癌16例临床诊治分析

目的探讨阑尾类癌的临床特点及诊治经验。方法对1990年1月~2005年1月收治的16例阑尾类癌病人的临床资料进行回顾性分析。结果16例病人中无1例术前明确诊断,均为术中发现或术后病理确诊。肿瘤直径<1 cm 11例,1~2 cm3例。>2 cm 2例。12例肿瘤浸润深度限于黏膜下或肌层,2例侵及浆膜,2例浸润至阑尾系膜,其中1例伴局部淋巴结转移。采用单纯性阑尾切除术12例。右半结肠切除4例。获随访的13例病人中,11例情况良好,无复发和远处转移,死亡2例,其中1例为非肿瘤性死亡,另1例死于肿瘤转移。结论阑尾类癌术前难以做出明确诊断,手术是主要的治疗手段,手术方式应根据肿瘤大小、部位及浸润深度来决定,化疗效果有待进一步研究。

The clinical analysis of 16 cases with appendiceal carcinoid

Aim To study the clinical features of the appendiceal carcinoid and experience of diagnosis and treatment in appendiceal carcinoid.Methods The clinical data of 16 cases with the appendiceal carcinoid from Jan 1990 to Jan 2005 were retrospectively analyzed.Results The diagnosis was established pathologically after operation in all patients.The tumor diameter was less than 1 cm in 11 cases,between 1 and 2 cm in 3 cases,and larger than 2 cm in 2 cases.Tumor invasion was confined to the submucosa or muscle layers in 12 cases,to serosan 2 case,and into appendicealmesenteriumin the remaining 2 cases with local lymph node metastasisin 1 case.Appendectomy was performed in 12 cases,right hemicolectomy in 4 cases.Among the 13 cases who were followed up,11 cases remained free of tumor recurrence and metastasis,and 1 patients died of metastasis.Conclusion Appendiceal carcinoid is rare and difficult to be diagnosed preoperatively.The operative principles and methods depend on the size,location and invasive depth of the tumor.The effect of chemotherapy needs to be investigated further.