阑尾类癌15例诊治分析

Carcinoid Tumors of the Appendix: A Report of 15 Cases

目的：探讨阑尾类癌的生物学特性、临床诊断和外科治疗经验。方法：回顾性分析本院自1985年-2005年收治的15例阑尾类癌患者的临床和病理资料。结果：本组15例患者均为术中发现或术后病理确诊。采用阑尾切除术11例，回盲部切除术1例，右半结肠切除术3例。肿瘤直径〈1cm12例，1～2cm2例，〉2cm1例。10例肿瘤浸润深度达黏膜下或肌层，3例侵及浆膜，2例浸润至阑尾系膜，其中1例患者肿瘤直径〉2cm伴局部淋巴结转移。随访15例，13例无复发及转移；2例局部复发，均行右半结肠切除术。结论：阑尾类癌少见且症状不典型，应根据肿瘤部位、大小、浸润深度及转移情况决定术式和切除范围。

Objective： To summarize the biological behavior of appendiceal carcinoid tumors and associated clinical experience with diagnosis and treatment. Methods： Clinical data of 15 cases with appendix carcinoid tumors receiving surgery in our hospital from 1985 to 2005 were retrospectively analysed. Results： The diagnosis of 15 cases was established pathologically after operation. Appendectomy was perfomed in 11 cases, ileocecoectomy in two and right-side coloneetomy in three. The tumor diameter was less than 1 cm in 12 cases,between 1 and 2 cm in two,and larger than 2 cm in one. Tumor invasion was confined to the submucosa or muscle layer in 10 cases,to serosa in three, and into mesoappendix in the remaining two cases （ one of whom had local lymph node metastasis and tumor diameter was larger than 2 cm）. 15 cases were followed up completely,and 13 cases remained free of recurrence and metastasis. Two cases suffered local recurrence and received right-side colonectomy. Conclusion： Appendiceal carcinoid is a rare condition with atypical symptoms. The operative principles and methods depend on the size, location, metastasis and depth of the tumor.