天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (10): 1080-1082.doi: 10.11958/20170468

• 临床研究 • 上一篇    下一篇

TNM 不同分期在阑尾神经内分泌肿瘤患者 预后评估中的价值

肖应泽 1，班东杰 1，魏建明 2，张升宁 3△   

  1. 1 天津市公安医院普通外科（邮编 300020）；2 天津医科大学总医院普通外科；3 昆明市第一人民医院普通外科
  • 收稿日期:2017-04-14 修回日期:2017-08-13 出版日期:2017-10-15 发布日期:2017-10-13
  • 通讯作者: 肖应泽 E-mail:13920761440@163.com
  • 作者简介:肖应泽（1977），男，硕士，主治医师,主要从事普外方面研究

The evaluation of different stages of TNM in prognosis of appendiceal neuroendocrine tumors

XIAO Ying-ze1, BAN Dong-jie1, WEI Jian-ming2, ZHANG Sheng-ning3△   

  1. 1 Department of General Surgery, Tianjin Police Hospital, Tianjin 300020, China; 2 Department of General Surgery, Tianjin Medical University General Hospital; 3 Department of General Surgery, Kunming First People’s Hospital
  • Received:2017-04-14 Revised:2017-08-13 Published:2017-10-15 Online:2017-10-13

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摘要： 目的 探讨 TNM 不同分期对阑尾神经内分泌肿瘤（NETs）患者预后的影响。方法 回顾性分析 40 例阑 尾神经内分泌肿瘤临床病理特点和手术情况。根据 2006 年欧洲神经内分泌肿瘤协会（ENETS）TNM 及 2010 年美国 癌症联合委员会（AJCC）TNM 分期标准分别对其预后进行评估并得到综合 TNM 分期，应用 Kaplan-Miere 生存曲线 分析比较 TNM 不同分期患者生存差异。结果 40 例阑尾 NETs 中术前无 1 例确诊为阑尾 NETs，术前诊断为急性阑 尾炎 21 例，慢性阑尾炎 16 例，因管腔明显增粗怀疑阑尾肿瘤 3 例。所有患者术前均无腹泻、腹痛、颜面潮红、哮喘 样发作等类癌综合征的表现；均行阑尾切除术，术后经病理确诊为阑尾 NETs。40 例阑尾神经内分泌肿瘤患者中Ⅰ 期 15 例（37.5%）、ⅡA 期 10 例（25%）、ⅢA 期 2 例（5%）、ⅢB 期 13 例（32.5%），无Ⅳ期病例；各期患者中位生存时间 分别为 27、22、21 及 18 个月，但累积生存率差异无统计学意义（χ2=0.898 8，P>0.05）。结论 阑尾神经内分泌肿瘤临 床表现无特异性，确诊需依据病理学及免疫组织化学检查，TNM 不同分期与患者预后生存率无明确关联。

关键词: 神经内分泌瘤, 阑尾, 肿瘤分期, 预后, Kaplan-Meier 评估, TNM 分期

Abstract: Objective To investigate the prognostic value of different stages of TNM in patients with appendiceal neuroendocrine tumors (NETs). Methods The clinical data of 40 cases of NETs were analyzed, and follow-up data were staged by the ENETS and AJCC TNM staging system. Kaplan- Miere survival curves were used to compare survival differences in patients with different stages of TNM. Results Of the 40 patients, no one was diagnosed as appendiceal NETs before surgery. Twenty-one patients were diagnosed as acute appendicitis, 16 were diagnosed as chronic appendicitis and 3 were suspected as appendiceal tumors due to thickening of the lumen before surgery. No clinical manifestations were found in 40 patients before surgery including diarrhea, abdominal pain, facial flushing, asthma- like seizures and other carcinoid syndrome performance. All patients underwent appendectomy, and appendix NETs were diagnosed by pathology after surgery. In 40 appendical NETs patients, 15 cases were classified as stage Ⅰ(37.5%), 10 cases were classified as stage ⅡA (25%), 2 cases were classified as stage ⅢA (5%), 13 cases were classified at stage ⅢB (32.5%), and no patients were classified as stage Ⅳ. The median survival times (months) were 27, 22, 21 and 18 for patients with different stages, and there were no significant differences in survival times between four stages (χ2=0.898 8，P>0.05). Conclusion The clinical features of appendical NETs are nonspecific. The diagnosis of appendical NETs is based on pathological examination and immunohistochemistry. There are no correlation between different TNM stages and prognosis of patients.

Key words: neuroendocrine tumors, appendix, neoplasm staging, prognosis, Kaplan-Meiers estimate, TNM staging