Survival and prognosis of 60 cases with appendix-derived high-grade mucinous adenocarcinoma
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摘要:
目的 探讨阑尾源性高级别黏液腺癌的临床特点并分析影响预后的因素。 方法 回顾性分析航天中心医院2013年1月至2017年12月期间收治的60例阑尾源性高级别黏液腺癌患者的临床及随访资料。 结果 60例阑尾源性高级别黏液腺癌患者中男性占48%（29例），女性占52%（31例）；发病的中位年龄为57（38~74）岁；术前化验血CEA升高者占65%（39例），术后行腹腔热灌注化疗者占80%（48例）。术后1、2、3年生存率分别为80%、58%、30%。中位生存时间为29个月。单因素分析腹膜癌指数（peritoneal cancer index, PCI）评分低及细胞减灭程度（completeness of cytoreduction，CC）愈小者对延长生存期有统计学意义（P=0.039，P=0.002）。多因素分析显示CC可作为影响总生存的独立预后因素（P=0.037）。 结论 阑尾源性高级别黏液腺癌具有高度侵袭性，预后较差，彻底减瘤对延长患者的生存有积极作用。早期发现、早期干预对患者预后有重要意义。 Abstract:Objective To investigate the clinical characteristics and prognostic factors associated with appendix-derived high-grade mucinous adenocarcinoma. Methods A retrospective analysis of clinical and follow-up data of 60 patients with appendix-derived highgrade mucinous adenocarcinoma admitted to Aerospace Central Hospital between January 2013 and December 2017 was carried out. Results Of the patients, 48% (29 cases) were men and 52% (31 cases) were women. The median age of the patients at admission was 57 (38-74) years. CEA levels increased in serum in 65% patients (39 cases) before operation, and hyperthermic intraperitoneal chemotherapy after operation accounted for 80% of the patients (48 cases). The 1-, 2- and 3-year survival rates were 80%, 58%, and 30%, respectively. The median survival time was 29 months. Univariate analysis showed that a lower peritoneal cancer index (PCI) score (P= 0.039) and a lesser degree of completeness of cytoreduction (CC) (P=0.002) were statistically significant in prolonging survival time. Multivariate analysis showed that the degree of CC could be an independent prognostic factor for overall survival (P=0.037). Conclusions Appendix-derived high-grade mucinous adenocarcinoma is highly invasive and features a poor prognosis, but radical tumor reduction has a positive effect on prolonging the survival of patients. Early detection and early intervention are of great significance for the prognostic outcome. -
Key words:
- appendix /
- mucinous adenocarcinoma (MAC) /
- survival /
- prognosis
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表 1 60例阑尾黏液腺癌患者生存期单因素分析
表 2 60例阑尾黏液腺癌患者生存预后的多因素分析
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