Clinical features of 30 cases of primary appendiceal mucinous adenocarcinoma

Objective　To analyze the clinical features of primary appendiceal mucinous adenocarcinoma (AMAC), and investigate the diagnosis and treatment principles of the disease. Methods　Thirty cases of primary AMAC from October 2011 to September 2019 in Daping Hospital of the Army Medical University were retrospectively analyzed, including demography, imaging, hematology, pathology and treatment method. Results　The main clinical features of the 30 cases were right lower abdominal pain. Of whom 12 cases were diagnosed as acute or chronic appendicitis before operation, and 8 cases were as combined with ovarian space occupying. Preoperative routine abdominal B ultrasonography combined with other imaging examinations (including abdominal CT, MRI and PET/CT) obviously improved the diagnostic accuracy (68.2%) than that with B ultrasonography alone (25.0%, P=0.049). Carcinoembryonic antigen (CEA) and carbohydrate antigens (CA199, CA125 and CA242) were the most common tumor markers, which had the highest diagnostic value for AMAC. Intestinal obstruction occured in four patients undergoing stage Ⅱ extended surgery, while in only three patients without undergoing stage Ⅱ extended surgery (Fisher's exact test, P=0.181). The mean survival time of patients with R0 resection was (57.5±9.5) months and the median survival time was 59.0 months. The mean survival time of patients without R0 resection was (29.8±4.1) months and the median survival time was 33.0 months (χ2=1.255, P=0.263). Conclusions　Appendiceal B ultrasound combined with abdominal enhanced MRI, CT or PET/CT can significantly improve the diagnostic rate of appendiceal mucinous adenocarcinoma. The monitoring of CEA, CA199, CA125, CA242 is helpful for the preoperative diagnosis of appendiceal mucinous adenocarcinoma. DOI: 10.11855/j.issn.0577-7402.2021.01.08