阑尾低级别黏液性肿瘤的诊疗进展

Diagnosis and treatment progress of low-grade appendiceal mucinous neoplasm

阑尾炎是急性腹痛的常见原因,急诊手术是初诊为阑尾炎患者的首选治疗方式。阑尾低级别黏液性肿瘤无特异性临床表现,通常在急性阑尾炎的阑尾切除标本中确定,术前诊断困难,临床多有误诊,确诊依赖于术中或术后病理结果。且术后存在肿瘤复发转移风险,严重影响患者预后。对于如何提高术前诊断准确性以及阑尾切除术后是否需要进一步治疗,目前国内外尚无针对性的临床指南或共识。文章旨在回顾与其诊治相关的文献,探究不同分期的阑尾低级别黏液性肿瘤最佳治疗方式,为制定临床诊疗策略提供理论依据。

Appendicitis is a common cause of acute abdominal pain,and emergency surgery is the first choice for patients newly diagnosed with appendicitis.Low-grade appendiceal mucinous neoplasm(LAMN)has no specific clinical manifestations and is usually identified in the appendectomy specimens of acute appendicitis.Preoperative diagnosis is difficult and often misdiagnosed clinically,and the diagnosis depends on the intraoperative or postoperative pathological results.Moreover,there is a risk of tumor recurrence and metastasis after surgery,which seriously affects the prognosis of patients.At present,there is no specific clinical guidelines or consensus at home and abroad on how to improve the accuracy of preoperative diagnosis and whether further treatment is needed after appendectomy.The purpose of this paper is to explore the best treatment methods of LAMN in different stages by reviewing the literature of diagnosis and treatment,and to provide theoretical basis for formulating clinical diagnosis and treatment strategies.