在尾切除术中发现的一种非穿孔的低级尾粘膜性瘤中,患上 pseudomyxoma peritonei 的风险
Chamila Lakmal1, Bipasha Chakrabarty1, Christine Tan2
1Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, UK.
概括
分类为pTis/pT3的低度尾粘膜性瘤 (LAMNs) 具有很小的发病瘤 (PMP) 的风险. 这些LAMN需要低强度监测,如果完全切除,就不需要进一步的手术.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 病理学 病理学 病理学
背景情况:
- 低度的尾粘膜性瘤 (LAMNs) 是伪肌瘤周周瘤 (PMP) 的前体.
- LAMN的分类包括无孔 (pTis,pT3) 和孔 (pT4) 类型.
- 在pTis和pT3 LAMNs中量化PMP风险对于管理至关重要.
研究的目的:
- 为了确定从pTis和pT3 LAMNs中发展PMP的风险.
- 为这些低风险的尾瘤建立适当的监测策略.
主要方法:
- 对前性收集的LAMN患者数据库 (2004-2019) 的回顾性分析.
- 排除pT4 LAMNs和其他尾瘤;病理学专家审查,手术笔记和CT扫描.
- 标准化的随访,包括监测CT和瘤标志物 (CEA,CA19-9,CA125).
主要成果:
- 包括193名pT3/pTis LAMNs患者 (pTis=153,pT3=40) 在内.
- 随访时间中位数为6.45年;8名患者 (4%) 失去了随访时间.
- 剩下的185名患者中没有一个患有PMP;5名患者 (2.5%) 患有R1切除.
结论:
- 在经过仔细的专家审查后,pTis/pT3 LAMNs的PMP发展风险可以忽略不计.
- 建议对正确分类的pTis/pT3 LAMNs进行低强度监测.
- 完整的切除消除了进一步手术的需要;R1切除需要在专业中心进行个性化评估.
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