appendiceal tumor

阑尾肿瘤
  • 文章类型: Journal Article
    背景:尽管阑尾肿瘤非常罕见,这一领域的研究已经加强,导致越来越多的研究和发表的论文。令人惊讶的是,没有全面的文献计量学分析专门针对阑尾肿瘤.
    目的:对阑尾肿瘤研究的现状和未来趋势进行全面分析。
    方法:在我们的文献计量分析研究中,我们探索了WebofScience核心收藏数据库。在R环境中使用文献计量学包自动转换和分析所选出版物的书目详细信息。此外,我们使用VoSviewer为各国创建合作网络图,机构,和作者,以及关键字的聚类图。此外,CiteSpace,另一个软件工具,用于构建期刊的双图叠加,并分析具有引文爆发的参考文献。
    结果:我们的研究纳入了2010年后发表的780篇英语文章。在过去十年中,相关出版物和引文的数量有所增加。美国在这方面领先,但是有必要改善国家和机构之间的合作与沟通。共现分析还揭示了不同作者之间的密切合作。《外科肿瘤学年鉴》是该领域最有影响力的期刊。分析具有高共同引用的参考文献和具有引用爆发的参考文献,与关键词和热点的分析一致,目前的研究主要集中在阑尾黏液性肿瘤和随后的腹膜假性黏液瘤的分类和治疗上。尽管有大量的临床研究,应进行更多深入的基础研究。
    结论:目前关于阑尾肿瘤的研究主要集中在阑尾黏液性肿瘤和腹膜假性黏液瘤的分类和治疗上。加强合作和基础研究对于进一步发展至关重要。
    BACKGROUND: Despite the rarity of appendiceal tumors, research in this field has intensified, resulting in a growing number of studies and published papers. Surprisingly, no comprehensive bibliometric analysis has specifically addressed appendiceal tumors.
    OBJECTIVE: To offer a thorough analysis of the current landscape and future trends in appendiceal tumor research.
    METHODS: In our bibliometric analysis studies, we explored the Web of Science Core Collection database. The bibliographic details of the chosen publications were automatically converted and analyzed using the bibliometric package in the R environment. Additionally, we employed VoSviewer to create cooperation network maps for countries, institutions, and authors, as well as clustering maps for keywords. Furthermore, CiteSpace, another software tool, was utilized to build dual-map overlays of journals and analyze references with citation bursts.
    RESULTS: Our study included 780 English-language articles published after 2010. The number of related publications and citations has increased in the past decade. The United States leads in this area, but there is a need to improve cooperation and communication among countries and institutions. Co-occurrence analysis also revealed close collaboration among different authors. Annals of Surgical Oncology was the most influential journal in this field. Analysis of references with high co-citations and references with citation bursts, consistent with analysis of keywords and hotspots, indicated that current research primarily centers on the classification and management of appendiceal mucinous neoplasms and consequent pseudomyxoma peritonei. Despite the abundance of clinical studies, a greater number of in-depth basic research studies should be conducted.
    CONCLUSIONS: Current research on appendiceal tumors focuses on classification and management of appendiceal mucinous neoplasms and pseudomyxoma peritonei. Enhanced collaboration and basic research are vital for further advancement.
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  • 文章类型: Journal Article
    背景:阑尾杯状细胞腺癌(AGCA)是2019年第5版WHO肿瘤分类中新提出的癌症类型。我们经历了这种罕见形式的阑尾原发性肿瘤。
    方法:一名85岁男性粪便隐血试验呈阳性。一系列的影像显示了1型肿瘤,位于阑尾口。随后的活检诊断为印戒细胞癌。因此,他接受了腹腔镜辅助回盲部切除术.最初,肿瘤被怀疑是杯状细胞类癌(GCC)。组织学和免疫染色结果之间存在差异:肿瘤细胞表现出与GCC的形态学相似性,然而,在免疫染色时显示有限的染色。最终,我们的结论是肿瘤应该被归类为AGCA,遵循世卫组织第5版。AGCA代表一种新分类的腺癌亚型。因为我们术前怀疑恶性肿瘤,我们进行了肿瘤切除和区域淋巴结清扫术,尽管大多数阑尾恶性肿瘤通常在阑尾切除术后被发现。
    结论:我们经历了一个案例,为理解AGCA提供了宝贵的见解,世界卫生组织第5版中最近建立的病理实体。本文是Azuma等人发表的病例报告的可接受的二级出版物。(JJpnSurgAssoc83:1103-1108,2022年)。
    BACKGROUND: Appendiceal goblet cell adenocarcinoma (AGCA) is a newly proposed cancer type in the 5th edition of the WHO Classification of Tumours in 2019. We experienced this rare form of appendiceal primary neoplasm.
    METHODS: An 85-year-old male presented a positive fecal occult blood test. A series of imagings revealed a type 1 tumor, located on the appendiceal orifice. The subsequent biopsy made the diagnosis of signet-ring cell carcinoma. Consequently, he underwent the laparoscopic-assisted ileocecal resection. Initially, the tumor was suspected to be a Goblet cell carcinoid (GCC). There was a discrepancy between the histological and immunostaining findings: the tumor cells exhibited morphological similarities to GCCs, however displayed limited staining upon immunostaining. Ultimately, we concluded that the tumor should be classified as AGCA, by following WHO 5th Edition. AGCA represents a newly categorized subtype of adenocarcinomas. Because of our preoperative suspicion of malignancy, we performed tumor resection with regional lymph node dissection, despite the fact that most appendiceal malignant tumors are typically identified after an appendectomy.
    CONCLUSIONS: We experienced a case that provides valuable insights into the comprehension of AGCA, a recently established pathological entity in the WHO 5th Edition. This article is an acceptable secondary publication of a case report that appeared in Azuma et al. (J Jpn Surg Assoc 83:1103-1108, 2022).
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  • 文章类型: Journal Article
    在腹膜假性黏液瘤(PMP)的治疗中建立了细胞减灭术(CRS)联合腹腔热化疗(HIPEC),选定的腹膜间皮瘤病例,在西方国家可切除的结直肠或卵巢腹膜转移。然而,这些技术的有效性和可行性在亚洲人群中还没有得到很好的证实,关于手术切除的PMP患者的长期生存结局的报道很少.
    回顾性分析2010年至2016年在日本新建立的腹膜恶性肿瘤病房连续接受CRS和HIPEC治疗PMP的患者的短期和长期结局的前瞻性数据库。
    共有105例患者接受CRS和HIPEC治疗,57例腹膜假性黏液瘤最大肿瘤减积(MTD)。在CRS组中,94例(90%)患者的原发肿瘤为阑尾,其次是卵巢和结直肠.22/105例患者(21%)发生了主要的术后并发症,其中1例住院死亡率(0.9%)。CRS组的5年总体生存率和无病生存率分别为74.2%和50.1%,分别。多变量分析显示,不利的组织学是总体生存率和无病生存率降低的重要预测因素。细胞减少的完整性,CA19-9和CA125也与无病生存率相关。
    这是关于CRS和HIPEC对亚洲人群PMP的长期结果和生存分析的第一份报告。CRS和HIPEC可以在合理的安全和有利的生存在一个新的中心进行。肿瘤完全切除和组织学类型是总体生存和无病生存的最强预后因素。
    UNASSIGNED: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is established in the management of pseudomyxoma peritonei (PMP), selected cases of peritoneal mesothelioma, and resectable colorectal or ovarian peritoneal metastases in Western countries. However, the efficacy and feasibility of these techniques are not well established in the Asian population, and little has been reported on long-term survival outcomes for surgically resected PMP patients.
    UNASSIGNED: Retrospective analysis of a prospective database of short- and longer-term outcomes of consecutive patients who underwent CRS and HIPEC for PMP in a newly established peritoneal malignancy unit in Japan between 2010 and 2016.
    UNASSIGNED: A total of 105 patients underwent CRS and HIPEC and 57 maximal tumor debulking (MTD) for pseudomyxoma peritonei. In the CRS group, the primary tumor was appendiceal in 94 patients (90%) followed by ovarian and colorectal. Major postoperative complications occurred in 22/105 patients (21%) with one in-hospital mortality (0.9%). The 5-year overall and disease-free survival rates for the CRS group were 74.2% and 50.1%, respectively. Multivariate analysis revealed unfavorable histology to be the significant predictor of reduced overall and disease-free survival. Completeness of cytoreduction, CA19-9, and CA125 were also associated with disease-free survival.
    UNASSIGNED: This is the first report on long-term outcomes and survival analysis of CRS and HIPEC for PMP in the Asian population. CRS and HIPEC can be conducted with reasonable safety and favorable survival in a new center. Complete tumor removal and histological type are the strongest prognostic factors for both overall and disease-free survival.
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  • 文章类型: Case Reports
    背景:阑尾肿瘤是在约2%的阑尾切除术中发现的罕见肿瘤。临床表现通常是无特异性的,非特异性腹痛或表现为急性阑尾炎或无症状。
    方法:我们介绍一例急性阑尾炎伴黏液囊肿的患者,然后归类为HAMN。该患者最初接受腹腔镜治疗,然后在开腹阑尾切除术中进行转换。组织学显示高度阑尾黏液性肿瘤局限于粘膜下层(pT3),伴有急性痰性阑尾炎。患者随后被送往转诊中心,在那里进行了HIPEC右半结肠切除术。
    结论:HAMN是一种罕见的实体,直到最近才被归类为一种新的阑尾黏液性肿瘤。由于所谓的更高的攻击性,必须将HAMN视为阑尾腺癌。这种罕见实体的治疗还没有很好的标准化,因为这种病很罕见.
    结论:HAMN是一种非常罕见的肿瘤。在紧急情况下,必须避免阑尾破裂,以降低腹膜假性黏液瘤的风险。病理学对于这些患者的进一步决定至关重要,并且在治疗和预后中起着非常重要的作用。
    BACKGROUND: Appendiceal tumors are rare neoplasms detected in about 2 % of appendicectomies. The clinical presentation is often unspecific, varying from unspecific abdominal pain or presenting as an acute appendicitis or being asymptomatic.
    METHODS: We present a case of a patient presenting as an acute appendicitis with a mucocele, and then classified as HAMN. The patient was treated with initial laparoscopic approach and then conversion in laparotomy with appendectomy. Histology demonstrated a high grade appendiceal mucinous neoplasm limited to submucosa (pT3), with concomitant acute phlegmonous appendicitis. The patient was subsequently sent to a referral center where a right hemicolectomy with HIPEC was performed.
    CONCLUSIONS: HAMN is a rare entity, only recently classified as a new kind of appendiceal mucinous neoplasm. Due to the supposed higher aggressivity, HAMN must be treated as an appendiceal adenocarcinoma. The treatment of this rare entity is not yet well standardized, because of the rarity of this disease.
    CONCLUSIONS: HAMN is a very rare tumor. In the emergency setting, it is mandatory to avoid rupture of the appendix, to minimize the risk of developing pseudomyxoma peritonei. Pathology is essential for further decisions in these patients and plays a very important role in treatment and prognosis.
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  • 文章类型: Journal Article
    世界卫生组织(WHO)第5版消化系统肿瘤分类区分了阑尾肿瘤(AT)的四类:锯齿状病变和息肉,粘液性肿瘤,腺癌,和神经内分泌肿瘤(NENs)。ATs的鉴别诊断在医学实践中可能具有挑战性,由于它们的稀有性和缺乏来自大型随机对照试验的数据,不同的患者群体。由于临床急性阑尾炎,通常在阑尾切除术期间获得的标本中注意到AT。在欧洲人口中,大多数AT(65%)发生在50岁以上和女性中(56.8%)。根据组织学类型,54.6%是神经内分泌肿瘤(NETs);26.8%是囊性肿瘤,粘液,和浆液性肿瘤;18.6%的腺癌未另作说明(NOS)。关于病理分析,大多数AT表现为良性病变或不需要进一步治疗措施的小NENs.阑尾粘液性肿瘤(AMN)的存在可导致腹膜假性黏液瘤(PMP)。虽然腹部恶性肿瘤的多模式治疗在过去的几十年中已经发展,ATs的临床检查和治疗仍然是一个挑战.因此,这篇综述旨在描述诊断的可能性,基于分子的诊断,分期,处理过程中的差异,以及与房性心动过速相关的预后因素。
    The 5th edition of the World Health Organization (WHO) classification of tumors of the digestive system distinguishes four categories of appendiceal tumors (ATs): serrated lesions and polyps, mucinous neoplasms, adenocarcinomas, and neuroendocrine neoplasms (NENs). The differential diagnosis of ATs can be challenging in medical practice, due to their rarity and lack of data from randomized controlled trials on a large, diverse group of patients. ATs are usually noted in specimens obtained during appendectomies due to clinical acute appendicitis. In the European population, most ATs (65%) occur over the age of 50 and among women (56.8%). According to histological type, 54.6% are neuroendocrine tumors (NETs); 26.8% cystic, mucinous, and serous neoplasms; and 18.6% adenocarcinoma not otherwise specified (NOS). On pathologic analysis, most AT findings are benign lesions or small NENs that do not require further therapeutic measures. The presence of appendiceal mucinous neoplasm (AMN) can lead to pseudomyxoma peritonei (PMP). While the multimodal treatment for abdominal malignancies has evolved over the past several decades, the clinical workup and treatment of ATs remain a challenge. Therefore, this review aims to describe the diagnostic possibilities, molecular-based diagnosis, staging, differences in the treatment process, and prognostic factors associated with ATs.
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  • 文章类型: Journal Article
    背景:杯状细胞腺癌是一种极其罕见的肿瘤,其中相同的细胞表现出粘液性和神经内分泌分化。与常规类癌相比,它被认为更具侵袭性,并且更容易引起转移。
    方法:我们报告一例杯状细胞腺癌伴腹膜转移。一名62岁的男子因急性阑尾炎接受了阑尾切除术。术中,在下腹部观察到炎性白色脓液和少量脏腹水,阑尾严重发炎。阑尾切除术期间收集的标本的组织病理学检查显示,杯状细胞腺癌的手术切缘阳性。一个月后,计划进行额外的回肠切除.腹腔镜检查显示整个腹腔有播散性结节。因此,患者接受了腹膜结节切除术。腹膜标本证实了组织病理学发现。因此,我们诊断为阑尾杯状细胞腺癌腹膜播散。
    结论:在急性阑尾炎手术中观察到白色脓液的病例,考虑到传播的可能性,收集样本进行组织病理学检查,开始早期治疗是至关重要的。
    BACKGROUND: Goblet cell adenocarcinoma is an extremely rare tumor in which the same cells exhibit both mucinous and neuroendocrine differentiation. It is considered more aggressive compared to conventional carcinoids and more likely to cause metastasis.
    METHODS: We report a case of goblet cell adenocarcinoma with peritoneal metastases. A 62-year-old man underwent appendectomy for acute appendicitis. Intraoperatively, inflammatory white pus and a small amount of dirty ascites were observed in the lower abdomen with severely inflamed appendix. Histopathological examination of the specimen collected during appendectomy revealed goblet cell adenocarcinoma with a positive surgical margin. One month later, additional ileal resection was planned. Laparoscopic examination revealed disseminated nodules throughout the abdominal cavity. Therefore, the patient underwent resection of the peritoneal nodules. The peritoneal specimens confirmed the histopathological findings. Thus we diagnosed the patient with peritoneal dissemination of appendiceal goblet cell adenocarcinoma.
    CONCLUSIONS: In cases wherein white pus is observed during surgery for acute appendicitis, considering the possibility of dissemination, collecting samples for histopathological examination, and initiating early treatment are crucial.
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  • 文章类型: Journal Article
    一名71岁的妇女在胃手术前在结肠镜检查(CS)中发现有粘膜下肿瘤样病变,计算机断层扫描(CT)显示阑尾底部有12毫米的结构。9个月后,CT无法清楚地检测到病变,但是一年后它在CT上再次扩大;因此,进行CS和内镜超声(EUS)检查。确定病变为囊性,内容物粘稠,并进行了腹腔镜阑尾切除术。这是通过切除标本的组织病理学检查诊断出的低度阑尾黏液性肿瘤(LAMN)的第一份报告,显示阑尾的收缩和再扩张。
    A 71-year-old woman was found to have submucosal tumor-like lesion on colonoscopy (CS) before gastric surgery, and computed tomography (CT) showed a 12-mm structure at the base of the appendix. The lesion could not be clearly detected on CT nine months later, but it had enlarged again on CT one year later; therefore, CS and endoscopic ultrasound (EUS) were performed. The lesion was determined to be cystic with viscous contents, and laparoscopic appendicectomy was performed. This is the first report of low-grade appendiceal mucinous neoplasm (LAMN) diagnosed by a histopathologic examination of a resected specimen showing shrinkage and re-expansion of the appendix.
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  • 文章类型: Journal Article
    目的:阑尾肿瘤(ANs)是一种罕见的肿瘤,通常在组织病理学检查中偶然发现。ANs发病率的增加是急性阑尾炎非手术治疗中的关键问题。本研究旨在通过分析临床表现来记录12年期间的时间趋势,影像学发现,和ANs的组织病理学特征。
    方法:对2011年至2022年接受阑尾切除术患者的健康记录进行检查。人口统计学和临床数据,实验室结果,影像学发现,并记录了组织病理学特征。评估了ANs和非肿瘤性病例的特征。
    结果:共确认22,304例,其中330例(1.5%)被诊断为ANs。ANs的赔率比随着年龄的增长而增加,在70岁或以上的患者中观察到最高的比值比。接收器工作特性分析表明,年龄和阑尾直径是AN的重要预测因素。确定了28.5岁的最佳年龄临界点,产生72%的灵敏度和64%的特异性。对于阑尾直径,发现最佳截止值为9.5毫米,表现出77%的灵敏度和56%的特异性。
    结论:尽管ANs的发病率仍然相对较低,在过去十年中,观察到稳步增加。AN率的增加引起了人们对非手术管理选择的担忧。这项研究的结果强调了将ANs作为老年患者和阑尾直径大于9.5mm的患者的潜在诊断的重要性。这些发现可能对治疗和管理有影响。
    Appendiceal neoplasms (ANs) are rare tumors that are often discovered incidentally during histopathological examinations. The increasing incidence of ANs is a critical issue in the non-operative management of acute appendicitis. This study aimed to document the temporal trends over a 12-year period by analyzing the clinical presentation, imaging findings, and histopathological features of ANs.
    Health records of patients who underwent appendectomy from 2011 to 2022 were examined. Demographic and clinical data, laboratory results, imaging findings, and histopathological features were documented. The characteristics of both ANs and non-neoplastic cases were evaluated.
    A total of 22,304 cases were identified, of which 330 (1.5%) were diagnosed with ANs. The odds ratio for ANs increased with age, with the highest odds ratio observed in patients aged 70 or older. Receiver Operating Characteristic analysis showed that age and appendiceal diameter were significant predictors of ANs. An optimal age cut-off point of 28.5 years was determined, yielding a sensitivity of 72% and a specificity of 64%. For appendiceal diameter, the optimal cut-off was found to be 9.5 mm, exhibiting a sensitivity of 77% and a specificity of 56%.
    Although the incidence of ANs remains relatively low, a steady increase has been observed over the past decade. The increasing rate of ANs raises concerns regarding non-surgical management options. The results of this study highlight the importance of considering ANs as a potential diagnosis in older patients and in patients with an appendix diameter greater than 9.5 mm. These findings may have implications for treatment and management.
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  • 文章类型: Randomized Controlled Trial
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  • 文章类型: Case Reports
    描述阑尾杯状细胞类癌是一种罕见的肿瘤,具有神经内分泌和腺癌的组织学特征。它的攻击性行为的结合,很少发生,和不同的临床表现完善了该肿瘤的管理。我们报告了一名75岁女性出现急性阑尾炎的病例。进行了腹腔镜阑尾切除术。病理报告显示阑尾底部有杯状细胞类癌,近端手术边缘受累。在她术后就诊时,患者的病理报告和治疗方案进行了审查,患者同意在阑尾切除术后8-10周进行右半结肠切除术。
    Description Goblet cell carcinoid of the appendix is a rare neoplasm with histological features of both neuroendocrine and adenocarcinomas. The combination of its aggressive behavior, infrequent occurrence, and variable clinical presentation convolutes the management of this tumor. We report the case of a 75-year-old female presenting with acute appendicitis. A laparoscopic appendectomy was performed. The pathology report showed goblet cell carcinoid at the base of the appendix with involvement of the proximal surgical margins. At her postoperative visit, the patient\'s pathology report and options for management were reviewed, and the patient agreed to proceed with a right hemicolectomy 8-10 weeks after her appendectomy.
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