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原发性阑尾肿瘤的临床特征和影像学表现
周法庭,杨振华,王毅,许俊,朱华,朱小勇
0
(三峡大学第一临床医学院·宜昌市中心人民医院,湖北 三峡大学消化疾病研究所;当阳长坂坡医院)
摘要:
【摘要】目的 分析原发性阑尾肿瘤患者的临床资料和辅助检查,旨在提高对原发性阑尾肿瘤的诊断水平。方法 通过院内病历系统搜集2012年5月~2016年6月期间的3286例阑尾手术患者病历资料,其中26例经术后病理证实为原发性阑尾肿瘤。进一步分析原发性阑尾肿瘤患者的临床表现、实验室检查和影像学表现,总结原发性阑尾肿瘤的发病特点。结果 在26例患者中,男性14 例,女性12 例,平均发病年龄(56.7±16.8)岁。症状以腹痛、腹部包块、恶心为主。癌胚抗原(CEA)和肿瘤标志物,糖类抗原(CA199)检查二者灵敏度分别为53.3%和33.3%;彩超检查病灶以混合性回声团为主;腹部CT特征性变化是阑尾增粗、囊壁增厚、周围渗出和淋巴结增多;结肠镜可发现包块,肠腔变窄。结论 原发性阑尾肿瘤缺乏典型的症状和体征,腹部CT亦无特定的影像学改变,结肠镜及肿瘤标志物检查灵敏度较低。因此,对于CT或彩超提示阑尾包块的患者,应联合CEA、CA 199和肠镜等检查结果综合判断,可明显提高诊断准确率。
关键词:  黏液腺癌  阑尾炎  CA199  腹腔假性黏液瘤
DOI:
基金项目:国家自然科学基金青年基金(31600134);宜昌市卫生科研资金资助(A16 301 08)
Research of clinical presentations and image features in the primary appendiceal carcinoma
ZHOU Fating,YANG Zhenhua,WANG Yi,XV Jun,ZHU Hua,ZHU Xiaoyong
(Dangyang Chang Banpo Hospital)
Abstract:
【Abstract】Objective This research was aimed to determinate the clinical and image data from the patients being diagnosed with primary appendiceal carcinoma and provide novel strategy with diagnosis. Methods The study of retrospective analysis investigate 3286 appendectomy data in the Yichang Central People’s Hospital from May 2012 to June 2016. 26 primary appendiceal carcinoma patients were confirmed by histopathological examination. The research was focused on the clinical presentations, laboratory examination and image features and the characteristics. ResultsmThe patients included 14 males and 12 females, the average age was 56.7±16.8. The common presentations were abdominal pain, abdominal mass and nausea. CEA and CA199 were easily to be forgotten before operation. The sensitivity of CEA and CA199 were 33.3% and 53.3%, respectively. Ultrasonography of the abdomen shown mixed echoic lesions. The characteristics of abdominal CT were enlarged appendix, thickened wall, effusion and increased lymph nodes. Colonoscopy may discover cauliflower mass and luminal narrowing. Conclusion The primary appendix carcinoma lacks specific clinical findings. There were no obvious findings in the abdomen CT. Colonoscopy and tumor markers may be ignorant. their sensitivity is also limitation. Therefore, it should be combined with CEA, CA 199 and colonoscopy and other examinations to make correct diagnosis quickly for appendiceal lesions in the CT or USG.
Key words:  Mucinous adenocarcinoma  Appendicitis  CA 199  Pseudomyxoma peritonei

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