原发性胆囊癌95例诊断与治疗体会  

Diagnosis and treatment of 95 cases of gallbladder cancer

作　　者：王约青[1] 

机构地区：[1]上海市闸北区中心医院外科,200070

出　　处：《临床外科杂志》2005年第7期441-442,共2页Journal of Clinical Surgery

摘　　要：目的探讨胆囊癌临床诊断与治疗方法。方法回顾性分析我院1983年1月～2003年1月收治经手术和病理检查证实的95例胆囊癌资料。结果95例中,男26例,女59例,年龄31～84岁,平均(61.9±12.1)岁,50岁以上占82%。全组71.6%(68/95)患者合并胆囊结石。早期临床无特异症状体征,中晚期主要症状体征为腹痛、黄疸、腹块、消瘦、胃肠反应。B超、CT、ERCP,血清CA199、CEA升高有助于术前诊断。TNM分期Ⅰ期9例、Ⅱ期9例、Ⅲ期12例、Ⅳa期18例、Ⅳb期47例。Ⅰ期患者单纯胆囊切除可以获得较好的预后,Ⅱ～Ⅳ期患者采用扩大的根治手术可以延长存活期。全组总的5年存活率为7.3%。结论术后生存期与分期密切相关,亦与手术方法有关。Objective To investigate the clinical methods for the diagnosis and treatment of gallbladder carcinoma.Methods The clinical data of 95 cases of gallbladder carcinoma confirmed operatively or pathologically from Jan.1983 to Jan.2003 were retrospectively analyzed.Results In all 95 patients,26 were males and 69 females with an average age of 61.9±12.1 years(ranging from 31 to 84).The patients over 50 years old,mostly females,were accounted for 82%(78/95),while most of the patients less than 40 years old were males.71.6%(68/95) of all patients were complicated with gallstone.In advanced and late stages the main symptoms and signs were abdomen pain,jaundice,mass in abdomen,weight-losing,and reactions of gastrointestine,but the patients were lack of specific symptoms and signs in early stage.Imaging BUS,CT and ERCP,serum tumor markers CA 19-9 and CEA,ALT,AKP and bilirubin were beneficial to the early diagnosis of gallbladder carcinoma.TMN staging:Ⅰ stage(9 cases),Ⅱ stage(9 cases),Ⅲ stage(12 cases),ⅣA stage(18 cases),ⅣB stage (47 cases).The 5-year survival rate was 7.3% in this group.Conclusion The prognosis of the gallbladder carcinoma is related with the staging of the disease and the surgical procedure.

关 键 词：胆囊癌 早期诊断 

分 类 号：R735.8[医药卫生—肿瘤]