Jordan F T, Mazzeo R J, Hoshal V L
Am Surg. 1983 May;49(5):278-81.
Adenocarcinoma of the appendix is a rare entity with a reported incidence of .03 to .08 per cent. A review of all appendectomies performed at St. Joseph Mercy Hospital (a private community hospital) between 1963 and 1979 was undertaken to assess the efficacy of preoperative diagnosis. Six adenocarcinomas were found, consisting of five male patients and one female patient with a mean age of 65 years. Symptoms were present for 24 hours or greater in all cases. A preoperative diagnosis was not made in any patient. Three patients later required a definitive therapeutic procedure, and two patients died from metastatic disease during their initial hospitalization. The literature was reviewed to evaluate methods of preoperative and intraoperative diagnosis of appendical adenocarcinoma. A suspicion of carcinoma of the appendix should be entertained for patients over the age of 50 years who present with signs and symptoms of appendicitis for greater than 24 hours. A barium enema performed preoperatively and especially a frozen section at the time of surgery of any suspicious appendiceal lesions may improve the diagnostic accuracy and survival of patients with this disease entity. If preoperative or intraoperative diagnosis is made, the patient can be better prepared and definitive surgical therapy carried out. This avoids delay in treatment and a second operative procedure.
阑尾腺癌是一种罕见的疾病，报告发病率为0.03%至0.08%。对1963年至1979年期间在圣约瑟夫慈善医院（一家私立社区医院）进行的所有阑尾切除术进行了回顾，以评估术前诊断的有效性。发现了6例腺癌，其中包括5例男性患者和1例女性患者，平均年龄为65岁。所有病例的症状持续24小时或更长时间。所有患者均未做出术前诊断。3例患者后来需要进行确定性治疗，2例患者在初次住院期间死于转移性疾病。回顾文献以评估阑尾腺癌的术前和术中诊断方法。对于年龄超过50岁、出现阑尾炎体征和症状超过24小时的患者，应怀疑患有阑尾癌。术前进行钡剂灌肠，特别是对任何可疑阑尾病变进行手术时的冰冻切片检查，可能会提高该疾病患者的诊断准确性和生存率。如果做出术前或术中诊断，可以让患者更好地做好准备并进行确定性手术治疗。这避免了治疗延误和二次手术。
