目的 探讨阑尾杯状细胞腺癌(goblet cell adenocarcinoma of the appendix,GCA)的规范诊断与治疗.方法 查阅国内外相关文献,对1例GCA患者的临床诊治进行回顾性分析.结果 患者男,64岁,当地医院行腹腔镜下阑尾切除术,术后病理诊断为GCA后,于南昌大学第一附属医院行腹腔镜下右半结肠根治性切除术,术后恢复可,无严重并发症,术后9 d出院,现已行2次奥沙利铂十左亚叶酸钙+氟尿嘧啶化疗方案以及6次奥沙利铂+卡培他滨规律化疗,术后随访19个月,未见明确肿瘤复发或转移.结论 阑尾肿瘤诊断缺乏特异性,若阑尾切除患者年龄较大、术前肿瘤标志物升高、阑尾管壁增厚、质硬或触及肿块时,应考虑阑尾肿瘤的可能性,必要时行术中冰冻切片送检,以达到一期根治的目的.
Abstract
Objective To explore the standardized diagnosis and treatment of goblet cell adeno-carcinoma of the appendix(GCA).Methods The relevant domestic and international literature was reviewed,and the clinical diagnosis and treatment of one patient with GCA was retrospective-ly analyzed.Results The patient,a 64-year-old male,underwentlaparoscopic appendectomy in a local hospital,and was transferred to the First Affiliated Hospital of Nanchang University to un-dergo laparoscopic radical resection of the right hemicolectomy after the diagnosis of GCA on postoperative pathology,and was discharged from the hospital 9 d after the operation with accept-able postoperative recovery and no serious complications.Two oxaliplatin+calcium levofolinate+fluorouracil chemotherapy regimens as well as six regular oxaliplatin+capecitabine chemotherapy regimens have been administered,and no definitive tumor recurrence or metastasis has been seen in the 19 months of postoperative follow-up.Conclusion The diagnosis of appendiceal malignancy lacks specificity.If the patient with suspected appendicitis is older,has elevated preoperative tumor markers,and has a thickened,hard or palpable appendiceal wall,the likelihood of malignancy should be considered,and intraoperative frozen sections should be performed and sent for exami-nation if necessary to achieve a one-stage radical cure.
关键词
阑尾杯状细胞腺癌/阑尾切除术/右半结肠根治性切除术/腹腔镜/病例报告
Key words
appendiceal goblet cell adenocarcinoma/appendectomy/radical resection of the right colon/laparoscopy/case report
维普
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