阑尾杯状细胞腺癌1例报告

Appendiceal Goblet Cell Adenocarcinoma:Case Report

目的探讨阑尾杯状细胞腺癌(goblet cell adenocarcinoma of the appendix,GCA)的规范诊断与治疗。方法查阅国内外相关文献,对1例GCA患者的临床诊治进行回顾性分析。结果患者男,64岁,当地医院行腹腔镜下阑尾切除术,术后病理诊断为GCA后,于南昌大学第一附属医院行腹腔镜下右半结肠根治性切除术,术后恢复可,无严重并发症,术后9 d出院,现已行2次奥沙利铂+左亚叶酸钙+氟尿嘧啶化疗方案以及6次奥沙利铂+卡培他滨规律化疗,术后随访19个月,未见明确肿瘤复发或转移。结论阑尾肿瘤诊断缺乏特异性,若阑尾切除患者年龄较大、术前肿瘤标志物升高、阑尾管壁增厚、质硬或触及肿块时,应考虑阑尾肿瘤的可能性,必要时行术中冰冻切片送检,以达到一期根治的目的。

Objective To explore the standardized diagnosis and treatment of goblet cell adenocarcinoma of the appendix(GCA).Methods The relevant domestic and international literature was reviewed,and the clinical diagnosis and treatment of one patient with GCA was retrospectively analyzed.Results The patient,a 64-year-old male,underwentlaparoscopic appendectomy in a local hospital,and was transferred to the First Affiliated Hospital of Nanchang University to undergo laparoscopic radical resection of the right hemicolectomy after the diagnosis of GCA on postoperative pathology,and was discharged from the hospital 9 d after the operation with acceptable postoperative recovery and no serious complications.Two oxaliplatin+calcium levofolinate+fluorouracil chemotherapy regimens as well as six regular oxaliplatin+capecitabine chemotherapy regimens have been administered,and no definitive tumor recurrence or metastasis has been seen in the 19 months of postoperative follow-up.Conclusion The diagnosis of appendiceal malignancy lacks specificity.If the patientwith suspected appendicitis is older,has elevated preoperative tumor markers,and has a thickened,hard or palpable appendiceal wall,the likelihood of malignancy should be considered,and intraoperative frozen sections should be performed and sent for examination if necessary to achieve a one-stage radical cure.