胆囊癌肝转移的临床病理学研究  

Hepatic metastasis from advanced gallbladder carcinoma:clinicopathological study

作　　者：周正[1,2] 潘瑞芹[1,2] 吉川达也 贾振庚[1,2] 

机构地区：[1]北京中日友好医院普外科 [2]日本东京女子医科大学消化器病中心外科

出　　处：《中华外科杂志》1998年第11期646-648,共3页Chinese Journal of Surgery

摘　　要：目的为了阐明胆囊癌肝转移（ＬｍＧｂＣａ）的相关临床病理学特点并为手术及术后继续治疗提供理论依据。方法用临床病理学方法对１５９例进行性原发胆囊癌进行对比研究。结果肝转移３１例（１９４％）。ＬｍＧｂＣａ的临床病理学特点显示肝转移与下列因素显著相关ｈｉｎｆ３（缩略语详见正文）（Ｐ＜００５），癌侵及达浆膜外或已侵及周围脏器（Ｐ＜００５），原发胆囊癌位于ｈｅｐ或ｃｉｒｃ（Ｐ＜００１），ｌｙ３（Ｐ＜００５），ｖ３（Ｐ＜００１）。结论前述３项大体临床病理学指标可以作为手术中选择术式的参考指标，其出现频率的算术增加可导致实际肝转移率的倍增。在手术中大体临床病理如果发现２项肝转移危险因素时应积极进行Ｓ４及Ｓ５的肝段切除，当大体临床病理发现１项肝转移危险因素，而术后组织学检查又发现中或重度的静脉或淋巴管浸润时。Objective To clarify the characteristics of the related clinicopathological factors in cases of liver metastasis from carcinoma of the gallbladder (LmGbCa),and to provide some insigts into the surgical management of LmGbca. Method One hundred fifty nine patients with subserosal (ss) cancer were studied. Result 31(19 4%) of the patients were found to have LmGbCa. Clinicopathologically, LmGbCa cases showed significant correlations with hinf 3 ( P <0 05),a depth of invasion of more than ss ( P <0 05), ly 3( P <0 05),v 3( P <0 01),and the location of the primary lesion on hep or circ ( P <0 01). Conclusion Hepatectomy of S4 and S5 segments shonld be used when 2 risk factors of liver metastases were found operatively, and radiation therapy or chemotherapy should be combined with resection when 1 risk factor of liver metastasis and lymphatic invasion was found.

关 键 词：胆囊肿瘤 肿瘤转移 胆道外科手术 肝转移 

分 类 号：R735.8[医药卫生—肿瘤]