论文部分内容阅读
目的探讨阑尾绒毛状管状腺瘤的临床病理特征、诊断及预后。方法回顾性分析10例阑尾绒毛状管状腺瘤的临床资料、病理学特征,并复习相关文献。结果患者中男性8例,女性2例,发病年龄25~72岁。肿瘤部位:7例位于阑尾中段,2例位于阑尾上段,1例位于阑尾孔。10例患者均因阑尾炎收治入院并手术,其中4例为术中外科医生剖视阑尾后发现肿瘤,6例为病理科医生取材发现肿瘤。肿瘤直径0.6~2cm,平均直径1.3cm。镜下肿瘤细胞排列成乳头状或腺管状,两者比例相近,肿瘤细胞有不同程度的异型增生,但未见间质浸润。免疫组织化学显示P53、Ki-67均有阳性表达,阳性肿瘤细胞数与异型增生程度呈正相关。除1例失访外,其余9例患者在随访期间均无复发。结论阑尾绒毛状管状腺瘤是一种少见的肿瘤,临床诊断识别较为困难,应加强对其认识,提高诊断率。
Objective To investigate the clinicopathological features, diagnosis and prognosis of villous tubular adenoma of the appendix. Methods Retrospective analysis of 10 cases of villous tubular adenoma of the clinical data, pathological features, and review the relevant literature. Results There were 8 males and 2 females, with a mean age of 25 ~ 72 years. Tumor site: 7 cases were located in the middle of the appendix, 2 cases were located in the upper appendix, and 1 was located in the appendix. All 10 patients were admitted to hospital for operation and were treated with appendicitis. Among them, 4 were intraoperative surgeons who found the tumor after dissecting the appendix and 6 were pathologists. Tumor diameter 0.6 ~ 2cm, the average diameter of 1.3cm. Microscopic tumor cells arranged in a papillary or glandular tubular, similar proportions of both, tumor cells have different degrees of dysplasia, but no interstitial infiltration. Immunohistochemistry showed that P53, Ki-67 were positive expression, positive tumor cells and the degree of dysplasia was positively correlated. Except for one case of missed follow-up, the remaining 9 patients showed no recurrence during follow-up. Conclusion The villous tubular adenoma of the appendix is a rare tumor. It is difficult to diagnose and identify the clinical diagnosis of the appendix and should be strengthened to improve the diagnosis rate.