虫垂腫瘍の臨床統計

Statistics of Appendiceal Malignant Tumors : Data from the JSCCR Registry and the Japan Autopsy Annual Database

要旨　大腸癌研究会の全国登録（JSCCR登録，1974～2004年）および日本病理学会の病理剖検輯報（JAAD，2000～2009年）からみたわが国の虫垂悪性腫瘍の統計データを概観した．虫垂悪性腫瘍罹患率は，JSCCR登録の大腸癌手術例においては0.2％，JAADの剖検例においては0.08％であった．JSCCR登録の全345例虫垂悪性腫瘍の大腸癌に占める発生割合は経年的に増加する傾向がみられ，診断時年齢は，男女ともに60歳代にピークがあった．組織型は分化型腺癌＞粘液癌＞印環細胞癌・低分化腺癌＞カルチノイドの順に多く，カルチノイドの割合が高い米国のデータベース（SEER）とは組織型の分布が乖離していた．虫垂悪性腫瘍の5年生存率は59.3％で，総じて結腸癌・直腸癌よりも低率であり，特にStage IIIは予後不良であったが，組織型別にSEERと比較すると，粘液癌と分化型腺癌の予後は良好であった．

　Based on data from the JSCCR registry（1974-2004）and the JAAD（2000-2009）, statistics of appendiceal malignancies（AMs）in the Japanese population were reviewed. The incidence of AMs was 0.2％ in the surgical cases of the JSCCR registry and 0.08％ in the autopsy cases of the JAAD, and there was an increasing trend in the incidence over the past 30years. Peak ages at time of diagnosis ranged from the 60s to 70s. The most common histology of the AMs was well to moderately differentiated adenocarcinoma, followed by mucinous carcinoma, signet ring cell carcinoma, poorly differentiated adenocarcinoma, and carcinoid tumor. The proportions of histological types differed considerably from those of the SEER data of the USA. The prognosis of the patients with appendiceal carcinoma was worse compared with colorectal cancer, and it was particularly true for patients with positive nodal involvement.