El-Esawy Basem Hassan, Abd El Hafez Amal, Abdelaziz Amany Mamdouh
Pathology Department, Faculty of Medicine, Mansoura University, El-Gomhouria Street, Mansoura, Dakahlia, Egypt.
Medical Laboratories Department, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.
J Gastrointest Cancer. 2020 Mar;51(1):10-16. doi: 10.1007/s12029-018-0182-4.
Mucinous appendiceal tumors (MATs) constitute 0.2-0.3% of appendectomies. This retrospective chart review study determines the incidence of MATs among appendectomies at King Abdul-Aziz Specialist Hospital, Taif City, Saudi Arabia, from January 2009 to December 2014. The clinicopathological features, histopathological criteria, management, outcomes of patients, and the impact of histopathological classification on the follow-up period and recurrence are evaluated.
Demographic and clinicopathological data were collected from medical records. Microscopic slides from 2476 appendectomies were re-examined to diagnose and classify MATs into low-grade mucinous neoplasms (LAMNs) and mucinous adenocarcinomas (MACAs). CK20, CK7, and cdx2 immunohistochemistry was applied for evaluating pseudomyxoma peritonei. Data were expressed as numbers, percentages, and mean ± standard deviation.
Nine MATs were diagnosed with an incidence of 0.36% of appendectomies, a male:female ratio of 1.25:1 and a mean age of 57.2 years. Acute appendicitis was the commonest clinical presentation. About 66.7% were LAMNs and 33.3% MACAs. Beside appendectomy, MACAs were managed with right hemicolectomy and chemotherapy. The median follow-up was 34 months with recurrence and liver metastases in two MACAs. No recurrences for LAMNs.
MATs constitute 0.36% of all appendectomies. Classifying MATs into LAMNs and MACAs is more applicable for both clinical and pathology practices as compared to the three- or four-tiered classification schemes.
黏液性阑尾肿瘤（MATs）占阑尾切除术的0.2 - 0.3%。本回顾性图表审查研究确定了2009年1月至2014年12月在沙特阿拉伯塔伊夫市阿卜杜勒 - 阿齐兹专科医院阑尾切除术中MATs的发生率。评估了患者的临床病理特征、组织病理学标准、治疗、结局以及组织病理学分类对随访期和复发的影响。
从病历中收集人口统计学和临床病理数据。重新检查2476例阑尾切除术的显微切片，以诊断MATs并将其分为低级别黏液性肿瘤（LAMNs）和黏液腺癌（MACAs）。应用细胞角蛋白20（CK20）、细胞角蛋白7（CK7）和尾型相关转录因子2（cdx2）免疫组织化学评估腹膜假黏液瘤。数据以数字、百分比和均值±标准差表示。
诊断出9例MATs，占阑尾切除术的0.36%，男女比例为1.25:1，平均年龄为57.2岁。急性阑尾炎是最常见的临床表现。约66.7%为LAMNs，33.3%为MACAs。除阑尾切除术外，MACAs采用右半结肠切除术和化疗。中位随访期为34个月，2例MACAs出现复发和肝转移。LAMNs无复发。
MATs占所有阑尾切除术的0.36%。与三级或四级分类方案相比，将MATs分为LAMNs和MACAs在临床和病理实践中更适用。
