Prior appendectomy does not protect against subsequent development of malignant or borderline mucinous ovarian neoplasms.
Prior appendectomy does not protect against subsequent development of malignant or borderline mucinous ovarian neoplasms.
复制标题
DOI：
10.1016/j.ygyno.2013.12.011
复制
发表时间：
2014-02
影响因子：
4.7
通讯作者：
Drapkin R
中科院分区：
文献类型：
--
作者：
Elias KM;Labidi-Galy SI;Vitonis AF;Hornick JL;Doyle LA;Hirsch MS;Cramer DW;Drapkin R
由于担心粘液性恶性或交界性卵巢肿瘤（MON）可能是原发性阑尾转移性沉积物，妇科肿瘤学家通常在这些情况下进行阑尾切除术。然而，缺乏对这种做法的多学科批评。利用新英格兰病例对照研究数据库比较既往阑尾切除术对MON已知危险因素的影响。回顾当地MON病例的病理和手术报告，以估计阑尾中显微镜下粘液性病变的频率。通过免疫组化比较粘液性卵巢癌、结直肠癌和阑尾癌的蛋白表达模式。来自新英格兰病例对照研究的287例MON与2,339例年龄匹配的对照进行了比较。既往阑尾切除术并不能降低MON的风险（OR 1.28，95%CI 0.83-1.92，p=0.23），而既往输卵管结扎术、产次和母乳喂养均能预防MON。主动吸烟（OR 2.04，95%CI 1.48-2.80，p<0.001）与MON风险增加相关。在196例粘液性附件肿瘤中，阑尾切除术未将任何MON重新分类为阑尾起源。通过免疫组化，粘液性卵巢癌倾向于CK 7 +/CK 20-/MUC 2-/CDX 2-，而粘液性结直肠腺癌和阑尾腺癌通常为CK 7-/CK 20 +/MUC 2 +/CDX 2+，尽管在免疫表型上有一些重叠。此外，PAX 8在MOC的一个亚组中呈阳性，在所有阑尾癌中呈阴性。既往阑尾切除术不能预防恶性或交界性MON的发展。常规阑尾切除术在手术中的MON很少发现一个未被怀疑的胃肠道原发性早期肿瘤，但可能有助于最终诊断的晚期病例。
Due to concern that mucinous malignant or borderline ovarian neoplasms (MON) may represent metastatic deposits from appendiceal primaries, gynecologic oncologists routinely perform appendectomy in these cases. However, a multidisciplinary critique of this practice is lacking. The New England Case-Control study database was utilized to compare the effect of prior appendectomy against known risk factors for MON. Pathology and operative reports of local cases of MON were reviewed to estimate the frequency of microscopic mucinous lesions in the appendix. Protein expression patterns among mucinous ovarian, colorectal, and appendiceal cancers were compared by immunohistochemistry. From the New England Case-Control study, 287 cases of MON were compared against 2,339 age-matched controls. Prior appendectomy did not reduce the risk of MON (OR 1.28, 95% CI 0.83–1.92, p=0.23), while prior tubal ligation, parity, and breastfeeding were each protective against MON. Active smoking (OR 2.04, 95% CI 1.48–2.80, p<0.001) was associated with an increased risk of MON. Among 196 mucinous adnexal tumors, appendectomy did not reclassify any MON as appendiceal in origin. By immunohistochemistry, mucinous ovarian carcinomas tended to be CK7+/CK20-/MUC2-/CDX2-, whereas mucinous colorectal and appendiceal adenocarcinomas were typically CK7-/CK20+/MUC2+/CDX2+, although with some overlap in immunophenotype. Additionally, PAX8 was positive in a subset of MOC and negative in all appendiceal carcinomas. Prior appendectomy is not protective against development of malignant or borderline MON. Routine appendectomy during surgery for MON seldom reveals an unsuspected GI primary in early stage tumors but may aid in final diagnosis in advanced stage cases.
登录
查看更多内容
DOI：
10.1016/s1470-2045(12)70322-4
发表时间：
2012-09
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Collaborative Group on Epidemiological Studies of Ovarian Cancer;Beral V;Gaitskell K;Hermon C;Moser K;Reeves G;Peto R
通讯作者：
Peto R
DOI：
10.1038/nrc3144
发表时间：
2011-09-23
期刊：
Nature reviews. Cancer
影响因子：
--
作者：
通讯作者：
--
影响因子：
5.6
作者：
Seidman, JD;Kurman, RJ;Ronnett, BA
通讯作者：
Ronnett, BA
影响因子：
7.2
作者：
Ayhan, A;Gultekin, M;Kucukali, T
通讯作者：
Kucukali, T
DOI：
10.1097/igc.0b013e31829b7dca
发表时间：
2013-09-01
影响因子：
4.8
作者：
Feigenberg, Tomer;Covens, Allan;Nofech-Mozes, Sharon
通讯作者：
Nofech-Mozes, Sharon