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[阑尾神经内分泌肿瘤的偶然发现]

[Incidental Finding of Appendiceal Neuroendocrine Tumour].

作者信息

Thomas Michael, Wahba Roger, Chiapponi Costanza, Stippel Dirk L, Bruns Christiane

机构信息

Klinik für Viszeral-, Allgemeine-, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Koln, Deutschland.

出版信息

Zentralbl Chir. 2022 Jun;147(3):244-248. doi: 10.1055/a-1798-0646. Epub 2022 Jun 15.

Abstract

With an incidence of 80%, neuroendocrine neoplasia (NEN) is the most common neoplasia of the appendix. In most cases, these tumours are diagnosed as an incidental finding after appendectomy with suspected appendicitis. They are usually highly differentiated neuroendocrine tumours. Due to their frequent location on the apex of the appendix, the NENs of the appendix are usually not the cause of the symptoms typical for appendicitis.Most patients (80-90%) receive adequate oncological treatment by laparoscopic or open appendectomy that has already been performed. However, if there are risk factors such as tumour size > 2 cm, location close to the base, angioinvasion, perforation or infiltration of neighbouring organs, proliferation index of > 2% or infiltration of the mesoappendix by more than 3 mm in the final histopathological finding, subsequent resection as an oncological right sided hemicolectomy is recommended .Due to their mostly early tumour stage at diagnosis without proven lymph node metastasis, patients with NEN of the appendix have an excellent 5-year survival rate of 70-85% across all tumour stages.

摘要

神经内分泌肿瘤(NEN)是阑尾最常见的肿瘤,发病率为80%。在大多数情况下,这些肿瘤是在因疑似阑尾炎行阑尾切除术后偶然发现的。它们通常是高分化神经内分泌肿瘤。由于阑尾神经内分泌肿瘤常位于阑尾尖端,通常不是阑尾炎典型症状的病因。大多数患者(80%-90%)已通过腹腔镜或开放阑尾切除术接受了充分的肿瘤治疗。然而,如果存在肿瘤大小>2cm、靠近阑尾根部、血管侵犯、穿孔或邻近器官浸润、增殖指数>2%或最终组织病理学检查中阑尾系膜浸润超过3mm等危险因素,则建议行肿瘤根治性右侧半结肠切除术。由于阑尾神经内分泌肿瘤在诊断时大多处于早期肿瘤阶段,且无证实的淋巴结转移,所有肿瘤分期的阑尾神经内分泌肿瘤患者5年生存率高达70%-85%,预后良好。

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