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低级别阑尾黏液性肿瘤(LAMN)的临床特征分析:51 例 LAMN 患者的回顾性队列研究。

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients.

机构信息

Department of General Surgery, Peking Union Medical College Hospital, Beijing, China.

出版信息

J Invest Surg. 2021 Jul;34(7):721-727. doi: 10.1080/08941939.2019.1695986. Epub 2020 Jan 6.

Abstract

INTRODUCTION

Low-grade appendiceal mucinous neoplasm (LAMN) is a rare disorder. There is no consensus on the prognosis and management of LAMN.

MATERIALS AND METHODS

We reviewed 51 consecutive patients with LAMN from 2013 to 2018. We divided our patients into two groups. The first is patients with an intact appendix. The second group comprises patients with the potential to develop a malignant condition. Comparisons of serum tumor markers between two groups were performed. Survival curves were estimated. Univariate and multivariate Cox proportional hazards were computed for 46 patients with median follow-up of 2.7 years.

RESULTS

Comparison of patients in two groups revealed significant differences in the mean level and abnormal ratio of CA125 ( < 0.001,  < 0.001), CA19-9 ( = 0.04,  = 0.04), and CEA ( = 0.001,  = 0.02). Eight patients had relapsed by the last follow-up in the second group. Patients with normal CEA had significantly longer disease-free survival (DFS) time than those with abnormal CEA ( = 0.04). CA19-9 exhibited a significant association with DFS (HR = 5.72,  = 0.02) in the Univariate Cox proportional hazards.

DISCUSSION

The prognosis of LAMN is related to serum tumor markers, the surgical procedure and the pathology.

摘要

简介

低级别阑尾黏液性肿瘤(LAMN)是一种罕见的疾病。目前对于 LAMN 的预后和处理尚无共识。

材料和方法

我们回顾了 2013 年至 2018 年间的 51 例连续 LAMN 患者。我们将患者分为两组,一组为阑尾完整的患者,另一组为有发展为恶性肿瘤潜能的患者。对两组患者的血清肿瘤标志物进行了比较,并绘制了生存曲线。对 46 例中位随访时间为 2.7 年的患者进行了单因素和多因素 Cox 比例风险分析。

结果

两组患者的 CA125( < 0.001, < 0.001)、CA19-9( = 0.04, = 0.04)和 CEA( = 0.001, = 0.02)均值和异常比例均有显著差异。在第二组中,有 8 例患者在最后一次随访时复发。CEA 正常的患者无疾病生存期(DFS)显著长于 CEA 异常的患者( = 0.04)。在单因素 Cox 比例风险分析中,CA19-9 与 DFS 显著相关(HR=5.72, = 0.02)。

讨论

LAMN 的预后与血清肿瘤标志物、手术方式和病理有关。

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