低级别阑尾黏液性肿瘤与卵巢黏液性囊腺瘤超声特征的对照研究

A study about the ultrasound features of low-grade appendiceal mucinous neoplasm versus ovarian mucinous cystadenoma

目的:探讨低级别阑尾黏液性肿瘤(low-grade appendiceal mucinous neoplasm,LAMN)与卵巢黏液性囊腺瘤(ovarian mucinous cystadenoma,OMC)超声特征的差异,为LAMN与OMC的鉴别诊断提供依据。方法:回顾并分析2010年8月—2023年7月复旦大学附属妇产科医院经术后病理学检查证实的35例低级别LAMN患者病史资料,与同期经术后病理学检查证实的40例OMC患者病史资料进行对比,分析其超声特征、一般资料及肿瘤标志物水平的差异。结果:LAMN超声特征多表现为“腊肠样”、不完全分隔的囊性或囊实性肿块,囊液多表现为“洋葱皮样”及“胶冻样”改变,可伴发腹膜假黏液瘤(pseudomyxoma peritonei,PMP),年龄多>55岁,血清癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原(carbohydrate antigen,CA)19-9、CA125可升高。OMC超声特征多表现为类圆形、完全分隔的囊性或囊实性肿块,囊液多表现为无回声及细密点状回声,年龄多<50岁,CEA、CA125、CA19-9升高不明显。结论:LAMN与OMC在肿块形状、分隔类型及囊液性状等超声特征方面具有明显差异,这些超声特征有望用于LAMN与OMC的鉴别诊断。

Objective:To explore the differences in ultrasound features between low-grade appendiceal mucinous neoplasm(LAMN)and ovarian mucinous cystadenoma(OMC),and to provide the basis for distinguishing LAMN from OMC.Methods:The medical history data of 35 patients with LAMN confirmed by pathology were retrospectively analyzed,as same as,the medical history data of 40 patients with OMC confirmed by pathology were retrospectively analyzed.All these patients had been treated surgically in the Obstetrics and Gynecology Hospital of Fudan University from August 2010 to July 2023.The differences in ultrasound features,general data and tumor markers were compared.Results:The ultrasound features of LAMN were mostly“Dachshund-like”,with incompletely separated cysts or cysts mixed with substantial components,and the liquid in the cyst was mostly characteristics of“onion skin-like”or“jelly-like”,which could be accompanied by pseudomyxoma peritonei(PMP).Most of the patients’ages were more than 55 years old,and the levels of carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9 and CA125 were elevated.The ultrasound features of OMC were mostly round,completely separated cysts or cysts mixed with substantial components.Liquid in the cyst was mostly anechoic or anechoic full of fine spots.Most of them were younger than 50 years old,and the levels of CEA,CA125,and CA19-9 were not significantly elevated.Conclusion:There are significant differences between LAMN and OMC in some ultrasound features,such as the shape of neoplasm,the type of septation and the characteristics of cystic fluid,which are expected to be used as markers for distinguishing LAMN from OMC.