Page 51 - World Journal of Laparoscopic Surgery

The Prevalence of Cancer in Patients Undergoing Appendectomy
20
19
Chinifroush et al. in Iran (0.0019%), Vessal et al. in Iran (0.0024%),
21
Guraya et al. in Saudi Arabia (0.0058%), and Tchana-Sato et al.
13
in Belgium (0.0040%). In a study performed by Ahmadi Nejad
et al. in Lorestan province, Iran, the prevalence of the appendix’s
carcinoid tumors in those with a history of an appendectomy was
22
reported at 0.17%. Although the prevalence of carcinoid tumors
in the general population of the United States has been estimated
23
to be 1–2 per 100,000 people, it seems that the actual prevalence
might be higher. Note that the incidence of carcinoid tumors is
24
often asymptomatic and can often remain so for years. Based
on the obtained results, although no significant relationship was
found between gender and the presence of malignant tumors of
the appendix, the frequency of malignant tumors was higher in
men. Unlike the results obtained from the present study, other
investigations have shown a higher incidence of the appendix’s
malignant tumors in women. 19,23,25 In our study, a significant
relationship was observed between presence of malignant tumors
Fig. 2: Comparison of the WBC count in those with malignant tumors of the appendix and age, with older individuals showing larger
and no tumor (n = 4940) numbers of malignant tumors. C-reactive protein assessment in
the patients showed 40.4% negative and 59.6% positive cases. No
significant relationship was found between CRP level and presence
of malignant tumors of appendix. C-reactive protein is an acute
phase reactant synthesized by the liver in response to infection.
The serum levels of this protein begin to rise 6–12 h after initiation
of tissue inflammation. C-reactive protein assessment is often done
easily and rapidly in laboratories, with studies showing that CRP
level can confirm appendicitis with high accuracy. 26,27

conclusIon
Since the diagnosis of malignant tumors of the appendix may not
be made easily, noting some variables, including advanced age and
high WBC count in the laboratory test, can help diagnose malignant
tumors. Moreover, given the malignancy as well as local invasion
and distant metastasis of some appendix tumors, follow-up of the
pathology report by the patient (especially older individuals) as well
as physician and during checkup following appendectomy within
short and regular intervals and if required follow-up treatment is
Fig. 3: CRP values in the studied population (n = 4940)
essential.
the studied population was 25.04 ± 23.98 mm/h. No significant
relationship was observed between ESR and the presence of AcknowledgMents
malignant tumors of the appendix. Moreover, the C-reactive protein The proposal of this research has been approved by the Research
(CRP) test results showed 40.4% negative and 59.6% positive cases. Deputy of Kermanshah University of Medical Sciences with the code
No significant relationship was observed between CRP level and of 980527. The authors highly appreciate those who cooperated
the presence of the appendix’s malignant tumors (Fig. 3). with us in this research, as well as the general surgeons of Imam
Reza Hospital in Kermanshah.
dIscussIon
This study investigated the prevalence of the appendix’s malignant orcId
tumors and determined the possible relationship between Mansour Rezaei https://orcid.org/0000-0002-6446-7289
these tumors and demographic and laboratory variables in
4940 patients with a history of appendectomy in Imam Reza
Hospital, Kermanshah. The results showed that the prevalence of references
the appendix’s malignant tumors in those who had undergone 1. Kooij I, Sahami S, Meijer S, et al. The immunology of the vermiform
appendectomy was 0.5%. Here, 61% of patients were male. In appendix: a review of the literature. Clin Exp Immunol 2016;186(1):1–9.
this regard, other studies have also shown a higher prevalence of DOI: 10.1111/cei.12821.
18
appendectomy among men. In the present research, the primary 2. Gebbers JO, Laissue JA. Bacterial translocation in the normal human
type of malignant tumor was mucinous adenocarcinoma (34.61%), appendix parallels the development of the local immune system.
Ann N Y Acad Sci 2004;1029:337–343. DOI: 10.1196/annals.1309.015.
followed by carcinoid tumor (23.07%). The prevalence of carcinoid 3. van Rossem CC, Bolmers MDM, Schreinemacher MHF, et al.
tumors in this study across the entire population was 0.0012%. Diagnosing acute appendicitis: surgery or imaging? Colorectal Dis
This value is slightly lower than the value obtained in the study by 2016;18(12):1129–1132. DOI: 10.1111/codi.13470.

World Journal of Laparoscopic Surgery, Volume 15 Issue 3 (September–December 2022) 237