Kepil Nuray, Batur Sebnem, Akinci Ozan, Pekmezci Salih
Department of Pathology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
Department of General Surgery, Hakkari State Hospital, Hakkari, Turkey.
North Clin Istanb. 2020 Jul 23;8(1):71-75. doi: 10.14744/nci.2020.49799. eCollection 2021.
During the microscopic examination of the specimens after appendectomy operations performed due to acute appendicitis, pathologists may encounter some incidental and unusual lesions. Appendectomy specimens are sampled as 3 sections/1 paraffin block in many centers. In this study, we aimed to evaluate whether multiple and dense sampling of appendix specimens has an impact on the incidence of incidental lesions of the appendix.
This study is a retrospective study of 1154 patients who underwent appendectomy with presumed acute appendicitis at the Department of General Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, had histopathological evaluation between 2007-2011 and 2014-2018. Group 1 was made up of the patients whose appendix specimens were examined as 3 sections/1 paraffin block. Group 2 was made up of the patients whose appendix specimens were sampled completely. In this study, it was evaluated whether there was a difference between the two groups concerning incidence of incidental benign and malign appendix lesions.
There were 579 patients in Group 1, 575 patients in Group 2, and the mean age of the groups was 26 and 28, respectively. Neither acute appendicitis findings nor any of the other unusual lesions were found in 57 specimens (9.8%) in Group 1 and 58 specimens (10.1%) in Group 2. Unusual pathological findings were detected in six specimens in Group 1 and 21 in Group 2. All unusual lesions, including benign and malignant, were significantly higher in Group 2 than in Group 1 (p=0.013). Concerning the incidence of malignant incidental lesions alone, there was no significant difference between the two groups (p=0.136).
Multiple and dense sampling of appendectomy specimens increases the likelihood of detecting unusual lesions of the appendix.
在对因急性阑尾炎进行阑尾切除术后的标本进行显微镜检查时，病理学家可能会遇到一些偶然的和不寻常的病变。在许多中心，阑尾切除标本按3个切片/1个石蜡块进行取样。在本研究中，我们旨在评估阑尾标本的多次密集取样是否会对阑尾偶然病变的发生率产生影响。
本研究是一项回顾性研究，对伊斯坦布尔大学-塞拉哈帕夏医学院普通外科接受疑似急性阑尾炎阑尾切除术的1154例患者进行研究，这些患者在2007 - 2011年和2014 - 2018年期间接受了组织病理学评估。第1组由阑尾标本按3个切片/1个石蜡块进行检查的患者组成。第2组由阑尾标本被完全取样的患者组成。在本研究中，评估了两组在阑尾偶然良性和恶性病变发生率方面是否存在差异。
第1组有579例患者，第2组有575例患者，两组的平均年龄分别为26岁和28岁。第1组的57个标本（9.8%）和第2组的58个标本（10.1%）中既未发现急性阑尾炎表现，也未发现任何其他不寻常病变。第1组在6个标本中检测到不寻常的病理发现，第2组在21个标本中检测到。包括良性和恶性在内的所有不寻常病变在第2组中均显著高于第1组（p = 0.013）。仅就恶性偶然病变的发生率而言，两组之间无显著差异（p = 0.136）。
阑尾切除标本的多次密集取样增加了检测到阑尾不寻常病变的可能性。
