阑尾神经内分泌肿瘤:单中心7266例阑尾切除术患者回顾性分析

Merve Tokoçin, Serhat Meriç, Haşim Furkan Güllü, Nihat Buğdaycı, Kamil Özdoğan, Onur Tokoçin, Osman Bilgin Gülçüçek
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摘要

目的:探讨急性阑尾炎后阑尾神经内分泌肿瘤(NETs)在腹腔镜或开放式阑尾切除术患者中的发生率。根据2010年世界卫生组织(WHO)的分类等级(手术切缘、侵袭、分级、TNM分期),我们塑造了肿瘤的特征,并探讨了这些患者的无病生存。材料与方法:回顾性分析7266例阑尾切除术患者的病历,并结合这些病例进行组织病理学分析,共43例诊断为NETs型阑尾炎纳入本研究。回顾性分析这些患者的年龄、性别、术中手术团队预测、肿瘤位置、WHO分级、浸润深度、阳性手术切缘、肿瘤大小、TNM分期及术后生存率。结果:本组7266例患者中,阑尾(NETs)发生率为0.59%。42例阑尾NETs患者中,女性27例,男性16例。患者平均年龄33.65岁(范围11-78岁)。诊断辅助临床检查,超声和腹部计算机断层扫描(CT)成像。大多数患者最初诊断为阑尾炎,并进行手术干预,包括腹腔镜和传统阑尾切除术。病理分析证实阑尾炎具有NETs,根据世卫组织2010年建议进行分类。大多数患者为高分化NETs (G1或G2)。手术切除桡骨缘阴性,随访结肠镜检查未发现病理征象。在中位70.2个月的随访中,所有患者均保持无病存活。结论:阑尾神经内分泌肿瘤是一种罕见但独特的肿瘤,需要多学科联合诊断和治疗。手术切除是主要的治疗方法,对晚期病例保留全身性治疗。预后一般良好,分化良好的肿瘤预后更好。长期随访至关重要。需要进一步的研究来提高对这些肿瘤的认识和优化治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neuroendocrine Tumor of The Appendix: Retrospective 7266 analysis of Appendectomy Patients in a single center
Objective: We aim to identify appendiceal neuroendocrine tumors (NETs) seen after acute appendicitis and investigate their incidence in patients with laparoscopic or open appendectomy surgery. Here we have shaped the characteristic features of the tumor according to the 2010 classification rating of The World Health Organization (WHO) (surgical margin, invasion, grading, TNM stages) and also explored the disease-free survival in these patients. Material and Methods: This is the medical record of the patient with 7266 appendectomy retrospectively evaluated, and with these examples in histopathological analysis, a total of 43 patients were diagnosed with appendicitis NETs and included in the study. Age, gender, prediction of the surgical team during the operation, location of the tumor, WHO grade, depth of invasion, positive surgical margin, tumor size, TNM stage, and postoperative survival of these patients were analyzed retrospectively. Results: In this study, the incidence of appendiceal (NETs) was found to be 0.59% among 7,266 patients. Out of the 42 patients with appendiceal NETs, 27 were female and 16 were male. The mean age of the patients was 33.65 years (range: 11–78). The diagnosis was aided by clinical examination, ultrasound, and abdominal computerized tomography (CT) imaging. Most patients were initially diagnosed with appendicitis, and surgical interventions, including laparoscopic and conventional appendectomy, were performed. The pathological analysis confirmed appendicitis with NETs, classified according to the WHO 2010 recommendation. The majority of patients had well-differentiated NETs (G1 or G2). Surgical resection achieved negative radial margins, and no pathological signs were detected during follow-up colonoscopies. At a median follow-up of 70.2 months, all patients remained disease-free and alive. Conclusion: Appendiceal neuroendocrine tumors are rare but distinct entities that require a multidisciplinary approach for diagnosis and management. Surgical resection is the primary treatment, with systemic therapies reserved for advanced cases. The prognosis is generally favorable, with better outcomes seen in well-differentiated tumors. Long-term follow-up is crucial. Further research is needed to improve understanding and optimize treatment strategies for these tumors.
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