阑尾原发恶性肿瘤临床病理特征分析

目的 本文旨在研究阑尾原发恶性肿瘤的临床病理特征及预后,评估影响阑尾原发恶性肿瘤生存的预后因素,为制定治疗方案,评估患者的预后提供参考。 方法 本研究纳入了SEER数据库2004-2010年阑尾原发恶性肿瘤病例。根据WHO第四版阑尾肿瘤分类,将阑尾原发恶性肿瘤中的腺癌、黏液腺癌、印戒细胞癌、神经内分泌肿瘤纳入研究。统计分析采用SPSS 19.0软件,生存率采用Kaplan-Meier方法计算生存曲线,使用Log-rank检验进行各组生存率之间的整体比较,P<0.05表示差异有统计学意义。用Cox回归多变量分析预后与性别、年龄、种族、组织学类型、肿瘤侵犯程度的关系。 结果 2004-2010年间,SEER数据库报道了3 967例阑尾恶性肿瘤,其中符合本研究纳入标准的有3 159例。校正年龄后的阑尾原发恶性肿瘤发病率为每0.7/100 000人。患者生存率与年龄成反比,非裔美国人的预后较其他人群更差。肿瘤侵犯程度越高,患者预后越差。各组织学类型中印戒细胞癌患者的疾病特异性生存率比其他类型肿瘤更低(P<0.001)。神经内分泌肿瘤患者生存率则较好(P<0.01)。 结论 阑尾原发恶性肿瘤的临床特征因组织学类型而不同。种族、年龄、分期、组织学类型、肿瘤侵犯程度和肿瘤原发灶大小是阑尾原发恶性肿瘤生存的独立预后因素。 

Clinicopathological characteristics of primary malignant neoplasms of the appendix

Objective To explore the clinicopathologic features and prognosis of primary malignant tumors of the appendix,assess the factors affecting the prognosis,and provide a reference for the development of treatment programs and evaluation of patients'prognosis. Methods This analysis included cases of malignant tumors of the appendix reported to the National Cancer Institute's Surveillance,Epidemiology and End-results (SEER) program between 2004 and 2010.Adenocarcinoma,mucinous adenocarcinoma,signet ring cell carcinoma and neuroendocrine tumor were included according to WHO Classification of Tumors of the Digestive System (Fourth Edition).Data analysis was performed using IBM SPSS software for Windows,version 19.0.Disease-specific survival was calculated according to the Kaplan-Meier method,and differences between curves were tested by the log-rank test,using P<0.05 as the limit of significance.Cox's proportional hazard regression analysis was performed using a multivariate analysis to identify independent prognostic factors in cancer patients. Results Between 2004 and 2010,3 967 malignant tumors of the appendix were reported to the SEER program,of which 3 159 cases were included in the analysis.The annual age-adjusted incidence of cancer of the appendix was 0.7 cases per 100 000 people.The survival rate was inversely proportional to age;African Americans had a worse prognosis than others.The higher the degree of tumor invasion,the worse the prognosis was.The disease specific survival rate of patients with signet ring cell carcinoma was lower than that of other types of tumors in all histological types (P<0.001).The patients with neuroendocrine tumors had a better prognosis (P<0.001). Conclusion The demographics of patients with primary malignant tumors of the appendix vary by histological classification.The race,age of diagnosis,grade,and histological types,the extent of the tumor at the time of diagnosis and tumor size were independent prognostic factors for primary neoplasms of the appendix.