Department of Surgery, Satasairaala Central Hospital, Pori, Finland.
University of Turku, Turku, Finland.
Int J Colorectal Dis. 2022 May;37(5):1173-1180. doi: 10.1007/s00384-022-04132-8. Epub 2022 Apr 26.
Recent studies have reported alarming appendiceal tumor rates associated with complicated acute appendicitis, especially in patients presenting with a periappendicular abscess. However, the data on histology of appendiceal tumors among acute appendicitis patients is limited, especially in patient cohorts differentiating between uncomplicated and complicated acute appendicitis. We have previously reported the association of increased appendiceal tumor prevalence with complicated acute appendicitis in this population-based study. The objective of this secondary analysis was to evaluate the association of both appendicitis severity and patient age with appendiceal tumor histology.
This nationwide population-based registry study (The Finnish Cancer Registry) was conducted from 2007 to 2013. All appendiceal tumors (n = 840) and available medical reports (n = 504) of these patients at eight study hospitals were previously evaluated, identifying altogether 250 patients with both acute appendicitis and appendiceal tumor.
The severity of acute appendicitis was significantly associated with more malignant tumor histology. The risk of adenocarcinoma or pseudomyxoma was significantly higher among patients with periappendicular abscess (OR 15.05, CI 95% 6.98-32.49, p < 0.001) and patients presenting with perforated acute appendicitis (OR 4.09, CI 95% 1.69-9.90, p = 0.0018) compared to patients with uncomplicated acute appendicitis. Similarly, patient age over 40 years was significantly associated with the risk of adenocarcinoma and pseudomyxoma (OR 26.46, Cl 95% 7.95-88.09, p < 0.001). Patient sex was not associated with a more malignant appendiceal tumor histology (p = 0.67).
More malignant appendiceal tumor histology of adenocarcinoma or pseudomyxoma was significantly associated with patient age over 40 years and complicated acute appendicitis, especially periappendicular abscess.
最近的研究报告了与复杂急性阑尾炎相关的令人震惊的阑尾肿瘤发生率，特别是在出现阑尾周围脓肿的患者中。然而，关于急性阑尾炎患者阑尾肿瘤组织学的数据有限，特别是在区分单纯性和复杂性急性阑尾炎的患者队列中。我们之前在这项基于人群的研究中报告了阑尾肿瘤患病率增加与复杂急性阑尾炎之间的关联。本二次分析的目的是评估阑尾炎严重程度和患者年龄与阑尾肿瘤组织学之间的关联。
这是一项全国性基于人群的注册研究（芬兰癌症登记处），于 2007 年至 2013 年进行。对这 8 家研究医院的 840 例阑尾肿瘤患者（n=840）和 504 例可用的医疗报告进行了评估，总共确定了 250 例同时患有急性阑尾炎和阑尾肿瘤的患者。
急性阑尾炎的严重程度与更恶性的肿瘤组织学显著相关。阑尾周围脓肿（OR 15.05，95%CI 6.98-32.49，p<0.001）和穿孔性急性阑尾炎（OR 4.09，95%CI 1.69-9.90，p=0.0018）患者发生腺癌或假性粘液瘤的风险明显高于单纯性急性阑尾炎患者。同样，40 岁以上的患者与腺癌和假性粘液瘤的风险显著相关（OR 26.46，95%CI 7.95-88.09，p<0.001）。患者性别与更恶性的阑尾肿瘤组织学无关（p=0.67）。
更恶性的阑尾肿瘤组织学，如腺癌或假性粘液瘤，与 40 岁以上的患者年龄和复杂的急性阑尾炎，特别是阑尾周围脓肿显著相关。
