Objective: To investigate the risk factors of peritoneal metastasis in primary appendiceal tumor. Methods: The clinic data of 71 patients with primary appendiceal tumor admitted in the Sixth Affiliated Hospital of Sun Yat-sen University between Dec 2012 and Jan 2019 were enrolled retrospectively. Multivariate logistic regression analysis were carried out to evaluate the risk factors of appendiceal tumor with peritoneal metastasis. Results: Of the 71 patients, 33 were peritoneal metastasis (peritoneal metastasis group) and 38 were non-peritoneal metastasis (no peritoneal metastasis group). Twenty-one patients in the peritoneal metastasis group had increased preoperative cancer embryo antigen (CEA), while 3 cases in the non-peritoneal metastasis group, with statistically significant difference (P<0.001). Sixteen cases in peritoneal metastasis group had increased preoperative carbohydrate antigen 199, while only 2 cases in the non-peritoneal metastasis group, the difference was statistically significant (P<0.001). The pathological type of 30 cases in the peritoneal metastasis group was adenocarcinoma (including mucus adenocarcinoma and colon adenocarcinoma), while 12 cases of adenocarcinoma in the non-peritoneal metastasis group, with statistically significant difference (P<0.001). Twelve cases in the peritoneal metastasis group had lymph node metastasis, while 3 cases in the non-peritoneal metastasis group, the difference is statistically significant (P=0.003). Preoperative CEA elevation and pathological type is adenocarinoma were independent risk factors for peritoneal metastasis of appendiceal cancer (P<0.05). Conclusions: The propensity of peritoneal metastasis in primary appendiceal tumor is high and the outcome is poor. Patients with increased preoperative CEA, adenocarcinoma histopathology are more inclined to have peritoneal metastasis.
目的： 探讨原发性阑尾肿瘤发生腹膜转移的危险因素。 方法： 回顾性分析2012年12月至2019年1月于中山大学附属第六医院就诊的71例原发性阑尾肿瘤患者的临床病理资料，采用多因素logistic回归分析原发性阑尾肿瘤腹膜转移的危险因素。 结果： 71例患者中，腹膜转移(腹膜转移组)33例，无腹膜转移(无腹膜转移组)38例。腹膜转移组患者术前癌胚抗原(CEA)升高21例，无腹膜转移组3例，差异有统计学意义(P<0.001)；腹膜转移组术前糖类抗原199升高16例，无腹膜转移组2例，差异有统计学意义(P<0.001)；腹膜转移组病理类型为腺癌(包括黏液腺癌和结肠型腺癌)30例，无腹膜转移组12例，差异有统计学意义(P<0.001)；腹膜转移组淋巴结转移12例，无腹膜转移组3例，差异有统计学意义(P＝0.003)。术前CEA升高、病理类型为腺癌为阑尾肿瘤发生腹膜转移的独立危险因素(均P<0.05)。 结论： 原发性阑尾肿瘤发生腹膜转移的概率高且预后差，术前CEA升高、病理类型为腺癌的阑尾肿瘤更有可能发生腹膜转移。.
Keywords: Appendiceal adenocarcinoma; Peritoneal metastasis; Primary appendiceal tumor; Risk factor.