Department of Gastrointestinal Surgery, The First Hospital, China Medical University, Shenyang, Liaoning Province, China.
Department of Gastrointestinal Surgery, The First Hospital, China Medical University, Shenyang, Liaoning Province, China.
Eur J Surg Oncol. 2018 Oct;44(10):1640-1645. doi: 10.1016/j.ejso.2018.06.037. Epub 2018 Jul 30.
Low-grade appendiceal mucinous neoplasms (LAMN) are poorly understood lesions characterized by their potential to spread to the peritoneal cavity as pseudomyxoma peritonei (PMP). The purpose of this study was to investigate the clinical and pathologic features and management of these tumors.
This was a retrospective study of consecutive patients with LAMN who underwent surgery by a surgical team at the First Affiliated Hospital of China Medical University between 2005 and 2016. Subgroup analyses were performed for patients with PMP.
The study included 50 LAMN patients, 13 of them with PMP. There were no significant differences in age (p = 0.293) or gender (p = 0.196) at diagnosis between the two groups. There was no significant difference in their presentation (p = 0.700). Although 5 patients with PMP had perforation of the appendiceal mucinous, acute peritonitis was uncommon. Microscopic examination detected that PMP without any obvious perforation in tumors shown mucin and/or mucinous epithelium herniating into the appendiceal wall, or as islands within these tissues. The patients underwent appendectomy, caecectomy and right hemicolectomy according to the intraoperative situation. The median follow-up period was 53 months (range 11-146 months). None of the patients developed clinical progression in either group during the follow-up period.
The age of LAMN at presentation was almost 60 years (56.7) and there was no clear gender predilection. When LAMN was treated surgically with resection of the primary site in early stage disease or with pushing invasion, there was an excellent prognosis and expanded surgical procedures were unnecessary.
低级别阑尾黏液性肿瘤（LAMN）是一种了解甚少的病变，其特征是有可能作为腹膜假性黏液瘤（PMP）扩散到腹腔。本研究的目的是探讨这些肿瘤的临床和病理特征及处理方法。
这是一项回顾性研究，纳入了 2005 年至 2016 年期间在中国医科大学第一附属医院接受手术的连续 LAMN 患者。对 PMP 患者进行了亚组分析。
研究共纳入 50 例 LAMN 患者，其中 13 例伴 PMP。两组患者在诊断时的年龄（p=0.293）或性别（p=0.196）无显著差异。两组患者的临床表现也无显著差异（p=0.700）。尽管 5 例 PMP 患者阑尾黏膜穿孔，但急性腹膜炎并不常见。显微镜检查发现，PMP 患者的肿瘤无明显穿孔，黏液和/或黏液上皮疝入阑尾壁，或存在于这些组织内的岛状结构。根据术中情况，患者行阑尾切除术、盲肠切除术和右半结肠切除术。中位随访时间为 53 个月（11-146 个月）。两组患者在随访期间均无临床进展。
LAMN 的发病年龄几乎为 60 岁（56.7 岁），无明显性别倾向。对于早期病变或有推挤性侵犯的 LAMN 患者，行原发病灶切除术可获得良好的预后，无需扩大手术范围。
