意外胆囊癌的临床病理特点与预后分析  

Analysis of the clinico-pathological features and prognosis of incidental gallbladder cancer

作　　者：欧阳杰[1] 汤地[1] 匡铭[1] 彭宝岗[1] 梁力建[1] 

机构地区：[1]中山大学附属第一医院肝胆外科,广州510080

出　　处：《中华临床医师杂志（电子版）》2011年第12期3441-3444,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广东省自然科学基金博士启动项目(07300945)

摘　　要：目的探讨意外胆囊癌的临床病理特点、治疗与预后。方法回顾性分析我院2001年1月至2009年12月手术治疗的意外胆囊癌共36例的临床资料、治疗方式以及预后。结果本组AJCC分期:0期2例,ⅠA期9例,ⅠB期11例,ⅡA期5例,ⅡB期1例,Ⅲ期2例,Ⅳ期6例。治疗方式包括单纯开腹胆囊切除术8例,腹腔镜胆囊切除10例;胆囊切除联合肝切除及区域淋巴结清扫16例;2例因病变晚期仅行剖腹探查术。本组无术后死亡。本组病例的1、3、5年生存率为:70.0%、60.0%、26.7%,生存分析显示胆囊壁增厚、淋巴结转移、肿瘤分期以及手术方式是影响术后生存的因素。结论早期的意外胆囊癌预后相对较好。对高发人群进行定期的随访、必要的影像学和肿瘤血清学检查以及及时的手术,对疑似患者进行术中冰冻切片检查,是提高胆囊癌检出率和改善预后的一个有效方法。Objective To investigate the clinico-pathological feature,surgical treatment and prognosis of incidental gallbladder cancer.Methods The clinico-pathological data and prognosis of 36 patients of incidental gallbladder cancer surgical treated in our hospital from January 2001 to December 2009 were retrospectively analyzed.Results According to the AJCC stage system for gallbladder cancer,there were 2 cases of stage 0,9,11 cases of stage ⅠA and ⅠB,5 cases of stage ⅡA,1 case of stage ⅡB,2 cases of stage Ⅲ and 6 cases of stage Ⅳ entered in this research.8 cases underwent open cholecystectomy and 10 underwent laparoscopic cholecystectomy.16 cases underwent open cholecystectomy combined with partial hepatectomy and regional lymph node dissection.2 cases underwent only exploratory surgery because of the late stage tumor.There were no perioperative deaths in this group of patients.The overall 1,3 and 5 year survival rates were 70.0%,60.0%and 26.7%respectively.Survival analysis showed that the thickness of gallbladder wall,regional LN metastasis,AJCC stage and surgery methods were the statistically significant factors that effecting the overall survival of patients.Conclusions Incidental gallbladder carcinoma can have good prognosis if treated in early stage.Regular following up for patients with high risk factors of gallbladder cancer,necessary radiological and ultrasound examinations and serological tests for tumor markers,timely surgery and intraoperative frozen section examination may be effective ways to increase the preoperative diagnosis rate and improve the prognosis of gallbladder carcinoma.

关 键 词：胆囊肿瘤 病理学 临床 疾病特征 预后 

分 类 号：R735.8[医药卫生—肿瘤]