Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan,
Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan.
Dig Surg. 2021;38(3):222-229. doi: 10.1159/000513973. Epub 2021 Mar 10.
Recently, "low-grade appendiceal mucinous neoplasms" (LAMNs) have been proposed as one subtype of appendiceal mucinous neoplasms, characterized by a villous or flat proliferation of mucinous epithelium with low-grade cytologic atypia. The aim of this study was to clarify the clinicopathological characteristics of LAMN.
In this multi-institutional cohort study, we retrospectively analyzed the clinicopathological characteristics in appendiceal neoplasms patients who underwent treatment from 2000 to 2017.
In total, 922 patients were enrolled, with 279 (30.3%) cases of LAMN, and 93 (10.1%) cases of non-LAMN disease. In comparison with patients with non-LAMN disease, those with LAMN had significantly lower levels of CA19-9 (p = 0.045), a lower frequency of T4 tumors (p < 0.0001), a lower frequency of lymph node metastasis (p < 0.0001), and a lower frequency of distant metastasis (p < 0.0001). Survival analysis revealed that patients with LAMN had a significantly better prognosis than did those with non-LAMN disease (p < 0.001). Among the patients with distant metastasis, those with LAMN had a significantly better prognosis than did those with non-LAMN disease (p = 0.0020), but among the patients without distant metastasis, the difference between the 2 groups was not significant (p = 0.26). However, among patients who underwent complete resection, the difference in prognosis between the 2 groups was not significant (p = 0.10).
A multicenter retrospective study revealed that the clinicopathological characteristics of LAMN was different from those of non-LAMN.
最近，“低级别阑尾黏液性肿瘤”（LAMN）被提议作为阑尾黏液性肿瘤的一个亚型，其特征为黏液上皮呈绒毛状或平坦状增生，具有低度细胞异型性。本研究旨在阐明 LAMN 的临床病理特征。
在这项多机构队列研究中，我们回顾性分析了 2000 年至 2017 年期间接受治疗的阑尾肿瘤患者的临床病理特征。
共纳入 922 例患者，其中 279 例（30.3%）为 LAMN，93 例（10.1%）为非 LAMN 疾病。与非 LAMN 疾病患者相比，LAMN 患者的 CA19-9 水平显著较低（p=0.045），T4 肿瘤的频率较低（p<0.0001），淋巴结转移的频率较低（p<0.0001），远处转移的频率较低（p<0.0001）。生存分析显示，LAMN 患者的预后明显优于非 LAMN 疾病患者（p<0.001）。在发生远处转移的患者中，LAMN 患者的预后明显优于非 LAMN 疾病患者（p=0.0020），但在无远处转移的患者中，两组间差异无统计学意义（p=0.26）。然而，在接受完全切除的患者中，两组间的预后差异无统计学意义（p=0.10）。
多中心回顾性研究显示，LAMN 的临床病理特征与非 LAMN 不同。
