临床外科杂志 ›› 2026, Vol. 34 ›› Issue (7): 762-764.doi: 10.3969/j.issn.1005-6483.20250917

• 临床病例报道 • 上一篇    下一篇

术后病理发现阑尾杯状细胞腺癌二例

顾丹阳,代扬,丁正华   

  1. 441002 湖北襄阳,武汉科技大学医学院襄阳市第一人民医院研究生联合培养基地普通外科(顾丹阳) ;湖北医药学院附属襄阳市第一人民医院普通外科(代扬、丁正华)
  • 收稿日期:2025-09-16 出版日期:2026-07-20 发布日期:2026-07-20
  • 通讯作者: 丁正华,Email:1357256337@qq.com
  • 作者简介:丁正华,Email:1357256337@qq.com
  • 基金资助:
    湖北省科技计划项目(2023EHA052);襄阳市第一人民医院科技创新项目(XYY2025SD10、XYY2025QN05)

Two cases of goblet cell adenocarcinoma of the appendix reported on postoperative pathology

GU Danyang, DAI Yang, DING Zhenghua   

  1. * Department of General Surgery, Joint Graduate Training Base of the School of Medicine, Wuhan University of Science and Technology and Xiangyang First People's Hospital, Xiangyang 441002, China
  • Received:2025-09-16 Online:2026-07-20 Published:2026-07-20

摘要: 病例1为91岁男性,因急性阑尾炎行阑尾切除术,术后病理检查提示阑尾杯状细胞腺癌(GCA),因高龄且合并多种基础疾病,未行根治手术或辅助化疗,术后1年随访未见复发;病例2为71岁男性,行右半结肠根治术联合术中腹腔灌注化疗,术后病理检查提示切缘阴性且淋巴结未见转移。免疫组化检测显示两例肿瘤细胞均表达CK20、CDX-2和SATB2,Ki-67增殖指数分别为30%和80%,提示肿瘤增殖活性存在较大差异。GCA临床极易漏诊,确诊需综合术中冰冻病理与术后免疫组化标记。治疗方面应注重个体化策略,对高龄、基础状况差者可考虑密切随访,进展期病人宜行根治性手术并结合辅助治疗。

关键词: 阑尾肿瘤, 杯状细胞腺癌, 病理诊断, 免疫组化

Abstract: Case 1 was a 91-year-old male underwent appendectomy for acute appendicitis.Postoperative pathology revealed GCA.Due to advanced age and multiple comorbidities, no further radical surgery or adjuvant chemotherapy was performed.One-year postoperative follow-up showed no signs of recurrence.Case 2 was a 71-year-old male who underwent radical resection of the right colon combined with intraoperative intraperitoneal chemotherapy.Postoperative pathology showed negative margins and no lymph node metastasis.Immunohistochemical analysis demonstrated that both tumor cells expressed CK20, CDX-2, and SATB2, with Ki-67 proliferation indices of 30% and 80%, respectively, indicating significant differences in tumor proliferative activity.Comprehensive analysis indicates that GCA is highly prone to clinical misdiagnosis, requiring confirmation through combined intraoperative frozen section pathology and postoperative immunohistochemical staining.Treatment should emphasize individualized strategies: close follow-up may be considered for elderly patients with poor baseline health, while advanced-stage patients are recommended for radical surgery combined with adjuvant therapy.

Key words: appendiceal tumours, goblet cell adenocarcinoma, pathological diagnosis, immunohistochemistry

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