胆囊上皮不典型增生与隐性胰胆反流  

Development of epithelial dysplasia in gallbladder with occult pancreatobiliary reflux

作　　者：钟征翔[1] 邬万新[2] 赵凤庆[1] 邹洪兴[3] 俞方荣[4] 

机构地区：[1]嘉兴医学院附属第一医院肝胆外科,浙江省314000 [2]嘉兴医学院附属第一医院病理科,浙江省314000 [3]嘉兴医学院附属第一医院检验科,浙江省314000 [4]嘉兴医学院附属第一医院放射科,浙江省314000

出　　处：《中华肝胆外科杂志》2008年第9期612-614,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的评价隐性胰胆反流与胆囊癌变的关系。方法检测340例择期胆囊切除术病人血液和胆囊胆汁淀粉酶确定隐性胰胆反流。组织病理学观察隐性胰胆反流胆囊标本的不典型增生发生率以及免疫组化观察胆囊黏膜上皮的增殖活性。结果340例择期胆囊切除标本中隐性胰胆反流发生率为9．4％（32／340）。32例隐性胰胆反流标本中发生胆囊癌1例，不典型增生11例。胆囊癌和不典型增生发生率为37．5％（12／32）。对照组发生不典型增生发生率8．4％（26／308），两组差异有显著意义（P=0．006）。隐性胰胆反流的胆囊上皮的Ki67指数平均为24．4％，高于对照组13．2％（p=0．014）。结论隐性胰胆反流是胆囊癌发生重要的诱因。Objective To investigate the role of occult pancreatobiliary reflux in gallbladder carcinogenesis. Methods The blood amylase and gallbladder bile amylase were measured, respectively, to diagnosis the occult pancreatobiliary reflux in 340 patients receiving selective cholecystectomy. The dysplasia and the proliferation activity in mueosa of gallbladders were detected histopathologically and immunohistochemically. Results The incidence of occult pancreatobiliary reflux was 9.4% （32/340）. One case of carcinoma and 11 cases of dysplasia were found in the 32 gallbladders with occult pancreatobiliary reflux. The incidence of carcinoma and dysplasia was 37.5% in gallbladders with occult pancreatubiliary reflux, which was higher than the control group with dysplasia incidence of 8.4% （P= 0. 006）. The average Ki67 index was 24.4 % in gallbladders with occult panereatobiliary reflux, which was higher than the control group with Ki67 index of 13.2% （P=0. 014）. Conclusion The occult pancreatobiliary reflux is an important factor to induce gallbladder cancer.

关 键 词：胆囊肿瘤 不典型增生 隐性胰胆反流 病理学 免疫组织化学 

分 类 号：R686[医药卫生—骨科学]