The 5th edition of the World Health Organization (WHO) classification of tumors of the digestive system distinguishes four categories of appendiceal tumors (ATs): serrated lesions and polyps, mucinous neoplasms, adenocarcinomas, and neuroendocrine neoplasms (NENs). The differential diagnosis of ATs can be challenging in medical practice, due to their rarity and lack of data from randomized controlled trials on a large, diverse group of patients. ATs are usually noted in specimens obtained during appendectomies due to clinical acute appendicitis. In the European population, most ATs (65%) occur over the age of 50 and among women (56.8%). According to histological type, 54.6% are neuroendocrine tumors (NETs); 26.8% cystic, mucinous, and serous neoplasms; and 18.6% adenocarcinoma not otherwise specified (NOS). On pathologic analysis, most AT findings are benign lesions or small NENs that do not require further therapeutic measures. The presence of appendiceal mucinous neoplasm (AMN) can lead to pseudomyxoma peritonei (PMP). While the multimodal treatment for abdominal malignancies has evolved over the past several decades, the clinical workup and treatment of ATs remain a challenge. Therefore, this review aims to describe the diagnostic possibilities, molecular-based diagnosis, staging, differences in the treatment process, and prognostic factors associated with ATs.
世界卫生组织（WHO）第五版消化系统肿瘤分类将阑尾肿瘤分为四类：锯齿状病变与息肉、黏液性肿瘤、腺癌以及神经内分泌肿瘤。由于阑尾肿瘤较为罕见，且缺乏针对大规模多样化患者群体的随机对照试验数据，其在临床实践中的鉴别诊断颇具挑战性。阑尾肿瘤通常是在因临床急性阑尾炎行阑尾切除术获得的标本中被发现。在欧洲人群中，大多数阑尾肿瘤（65%）发生在50岁以上人群，且女性居多（占56.8%）。按组织学类型划分，54.6%为神经内分泌肿瘤，26.8%为囊性、黏液性和浆液性肿瘤，18.6%为非特指型腺癌。病理分析显示，大多数阑尾肿瘤为良性病变或小型神经内分泌肿瘤，无需进一步治疗措施。阑尾黏液性肿瘤的存在可能导致腹膜假性黏液瘤。尽管过去几十年来腹部恶性肿瘤的多模式治疗已取得进展，但阑尾肿瘤的临床检查与治疗仍面临挑战。因此，本综述旨在阐述阑尾肿瘤的诊断可能性、基于分子学的诊断方法、分期标准、治疗过程中的差异以及相关的预后因素。
Current Status of Treatment among Patients with Appendiceal Tumors—Old Challenges and New Solutions?
肿瘤(癌症)患者之家