原发性阑尾腺癌八例临床诊治分析

Clinical analysis for diagnosis and treatment of eight cases of primary appendiceal adenocarcinoma

目的 探讨原发性阑尾腺癌的诊断和治疗要点.方法 回顾性分析8例原发性阑尾腺癌患者的临床资料.结果 原发性阑尾腺癌占同期阑尾切除标本的0.13％（8/6 069）,8例患者中术前仅有1例明确诊断,术前常规腹部CT检查有一定的诊断价值.其中2例一期行根治性右半结肠切除术,5例二期行根治性右半结肠切除术.2例术后辅以化疗.结论 原发性阑尾腺癌发病率低,缺乏特异性临床特征,术前诊断困难,误诊率极高,根治性右半结肠切除术是常规推荐的手术方式,术后应根据分期辅以化疗.

Objective To explore the clinical diagnosis and treatment of primary appendiceal adenocarcinoma.Methods The clinical data of 8 patients with primary appendiceal adenocarcinoma were retrospectively analyzed.Results The cases of primary appendiceal adenocarcinoma accounted for all appendectomy specimens of 0.13％ （8/6 069）.Among them,only 1 case was diagnosed correctly before operation,preoperative conventional abdominal CT examination was valuable for the diagnosis.One stage right hemicolectomy was performed in 2 cases,two stage right hemicolectomy was carried out in 5 cases.Postoperatively systemic chemotherapy was performed in 2 cases.Conclusions Lack of particular presentation,primary appendiceal adenocarcinoma is uncommon and difficult to be diagnosed exactly,preoperative misdiagnosed rate is very high.Right hemicolectomy is the most commonly recommended surgical option,systemic chemotherapy should be offered according to the stage.