From the W. Norman Thornton Division of Gynecologic Oncology Department of Obstetrics and Gynecology and the Department of Pathology, University of Virginia Health System, Charlottesville, Virginia.
Obstet Gynecol. 2010 Dec;116(6):1348-1353. doi: 10.1097/AOG.0b013e3181fae628.
To investigate the prevalence of appendiceal pathology in women undergoing surgery for a suspected ovarian neoplasm and the predictive value of intraoperative findings to determine the need for appendectomy at the time of surgery.
Retrospective analysis of patients who underwent oophorectomy and appendectomy during the same surgical procedures at the University of Virginia Health System from 1992 to 2007. Observations were stratified based on the nature (benign, borderline, or malignant) and histology (serous compared with mucinous) of the ovarian neoplasm, frozen compared with final pathological diagnosis, and the gross appearance of the appendix.
Among the 191 patients identified, frozen section was consistent with seven mucinous and 35 serous carcinomas, 16 serous and 33 mucinous borderline tumors, 71 mucinous and serous cystadenomas, and 29 cases of suspected metastatic tumor from a gastrointestinal primary. The highest rates of coexisting appendiceal pathology were associated with serous ovarian cancers (94.4% of grossly abnormal and 35.3% of normal appendices) and ovarian tumors suspected to be of primary gastrointestinal origin (83.3% grossly abnormal and 60.0% normal appendices harbored coexisting mucinous neoplasms). Linear regression analysis revealed that appearance of the appendix and frozen section diagnosis of the ovarian pathology were statistically significant predictors of coexisting appendiceal pathology, but the latter was more important.
The prevalence of coexisting, clinically significant appendiceal pathology is low with a frozen section diagnosis of serous or mucinous cystadenoma. Appendectomy is recommended when frozen section diagnosis is mucinous or serous ovarian carcinoma, borderline tumor or metastatic carcinoma of suspected gastrointestinal origin.
调查在因疑似卵巢肿瘤而行手术的女性中阑尾病变的发生率，以及术中发现对确定手术时是否需要行阑尾切除术的预测价值。
对 1992 年至 2007 年在弗吉尼亚大学健康系统接受卵巢切除术和阑尾切除术的患者进行回顾性分析。根据卵巢肿瘤的性质（良性、交界性或恶性）和组织学（浆液性与黏液性）、冰冻切片与最终病理诊断以及阑尾的大体外观对观察结果进行分层。
在 191 例患者中，冰冻切片与 7 例黏液性和 35 例浆液性癌、16 例浆液性和 33 例黏液性交界性肿瘤、71 例黏液性和浆液性囊腺瘤以及 29 例疑似胃肠道原发性转移瘤一致。共存阑尾病变的最高发生率与浆液性卵巢癌相关（大体异常的阑尾中 94.4%，正常阑尾中 35.3%）和疑似胃肠道原发性来源的卵巢肿瘤（大体异常的阑尾中 83.3%，正常阑尾中 60.0%存在共存的黏液性肿瘤）。线性回归分析显示，阑尾外观和卵巢病理的冰冻切片诊断是共存阑尾病变的统计学显著预测因子，但后者更为重要。
对于冰冻切片诊断为浆液性或黏液性囊腺瘤的患者，共存的、具有临床意义的阑尾病变发生率较低。当冰冻切片诊断为黏液性或浆液性卵巢癌、交界性肿瘤或疑似胃肠道来源的转移性癌时，建议行阑尾切除术。
