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目的本文旨在研究阑尾原发恶性肿瘤的临床病理特征及预后,评估影响阑尾原发恶性肿瘤生存的预后因素,为制定治疗方案,评估患者的预后提供参考。方法本研究纳入了SEER数据库2004—2010年阑尾原发恶性肿瘤病例。根据WHO第四版阑尾肿瘤分类,将阑尾原发恶性肿瘤中的腺癌、黏液腺癌、印戒细胞癌、神经内分泌肿瘤纳入研究。统计分析采用SPSS 19.0软件,生存率采用Kaplan-Meier方法计算生存曲线,使用Log-rank检验进行各组生存率之间的整体比较,P<0.05表示差异有统计学意义。用Cox回归多变量分析预后与性别、年龄、种族、组织学类型、肿瘤侵犯程度的关系。结果 2004—2010年间,SEER数据库报道了3 967例阑尾恶性肿瘤,其中符合本研究纳入标准的有3 159例。校正年龄后的阑尾原发恶性肿瘤发病率为每0.7/100 000人。患者生存率与年龄成反比,非裔美国人的预后较其他人群更差。肿瘤侵犯程度越高,患者预后越差。各组织学类型中印戒细胞癌患者的疾病特异性生存率比其他类型肿瘤更低(P<0.001)。神经内分泌肿瘤患者生存率则较好(P<0.01)。结论阑尾原发恶性肿瘤的临床特征因组织学类型而不同。种族、年龄、分期、组织学类型、肿瘤侵犯程度和肿瘤原发灶大小是阑尾原发恶性肿瘤生存的独立预后因素。
Objective To study the clinicopathological features and prognosis of primary appendectomy and to evaluate the prognostic factors that affect the survival of primary appendectomy and to provide a reference for developing treatment plan and evaluating the prognosis of patients. Methods This study included cases of primary appendectal malignancy from 2004 to 2010 in the SEER database. According to the fourth edition of the WHO classification of appendicitis, adenocarcinoma, mucinous adenocarcinoma, signet ring cell carcinoma and neuroendocrine tumors in the primary appendectomy were included in the study. The statistical analysis was performed using SPSS 19.0 software. The survival rate was calculated by Kaplan-Meier method. The overall survival rate was calculated by Log-rank test. P <0.05 was considered statistically significant. Multivariate Cox regression was used to analyze the relationship between prognosis and gender, age, ethnicity, histological type, and extent of tumor invasion. Results Between 2004 and 2010, the SEER database reported 3 967 cases of appendix malignancy, of which 3 159 met the criteria for inclusion in this study. The incidence of primary appendiceal malignancies after correction for age was 0.7 / 100 000 people. Patients’ survival rates are inversely proportional to age, and African Americans have a worse prognosis than the rest of the population. The higher the degree of tumor invasion, the worse the prognosis of patients. Patients with signet ring cell carcinoma in each histological type had a lower disease-specific survival rate than those with other types of tumors (P <0.001). Neuroendocrine tumor survival rate was better (P <0.01). Conclusions The clinical features of the primary appendectomy differ depending on the histological type. Race, age, stage, histological type, extent of tumor invasion, and tumor size were independent prognostic factors for the survival of the primary appendix.