胆囊息肉样变的M值临床意义  

Clinical significance of M value in gallbladder polypoid lesions

作　　者：王彦超[1] 张小昭 连文波 张示杰[1] 

机构地区：[1]石河子大学医学院第一附属医院肝胆外科,新疆维吾尔自治区石河子市832000

出　　处：《世界华人消化杂志》2015年第11期1829-1833,共5页World Chinese Journal of Digestology

基　　金：国家科技支撑计划基金资助项目;No.2013BAI05B00;新疆建设兵团科技计划基金资助项目;No.2013AB026~~

摘　　要：目的:探讨根据胆囊息肉样变的超声影像学特征计算得到的M值对胆囊息肉样变临床诊断和治疗的指导意义.方法:收集2011-01/2013-12收治的114例胆囊息肉样变患者临床资料,记录所有患者术前超声的影像学特点:大小、部位、单发或多发、蒂是否宽大、回声强度、胆囊壁是否增厚、息肉样病变边缘是否光滑等,按照M值公式(M=0.02×年龄+0.31×X1+0.9×X2+0.15×X3-5.5)计算得出M值,并结合术后病理分型进行统计学分析.结果:术后经病理诊断为不同类型胆囊息肉或胆囊癌114例,其中胆固醇性息肉79例(69.30%),炎症息肉14例(12.28%),胆囊腺肌增生症3例(2.63%),腺瘤性息肉4例(3.51%),腺瘤恶变4例(3.51%),胆囊癌10例(8.77%);M<0者93例(81.58%);均为良性病变;0≤M<2.5者7例(6.14%),4例良性病变,2例癌前病变,1例恶性病变;M≥2.5者14例(12.28%),13例恶性病变,1例癌前病变.M值与病理分型具有正相关关系(r=0.881,P<0.001),即M值越大,胆囊息肉样变可能为恶性的程度越高.,结论:通过M值可初步预测胆囊息肉样变的良恶性,对其临床诊断和指导治疗具有重要意义.AIM： To investigate the clinical significance of M value, which is calculated according to ultrasonic features of gallbladder polypoid lesions. METHODS： Clinical data for 114 patients with gallbladder polypoid lesions were collected from January 2011 to December 2013 at the First Affiliated Hospital of Medical College of Shihezi University. The data recorded all patients’ ultrasonic characteristics including lesion size, location, number, pedicle size, echo intensity, gallbladder wall thickening or not, and boundary of polypoid lesions. The M value was calculated according to the formula M = 0.02 × age ＋ 0.31 × X1 ＋ 0.9 × X2 ＋ 0.15 × X3- 5.5, and postoperative pathology was used as a reference.RESULTS： The 114 patients were divided into different types of gallbladder polypoid lesions or gallbladder cancer after surgery according topathological diagnosis. Among these patients, 79（69.30%） had cholesterol polyps, 14（12.28%） had inflammatory polyps, 3（2.63%） gallbladder adenomyomatosis, 4（3.51%） adenomatous polyps, 4（3.51%） malignant adenomas, and 10（8.77%） gallbladder cancer. Among them, 93（81.58%） cases had an M value 〈 0 and all of them were benign lesions; 7（6.14%） cases had an M value ≥ 0 but 〈 2.5, including 4 benign lesions, 2 precancerous lesions, and 1 malignant lesion; 14（12.28%） cases had an M value ≥ 2.5, including 13 malignant lesions and 1 precancerous lesion. There was a positive correlation between M value and pathological type（r = 0.881, P 〈 0.001）.CONCLUSION： The M value has important significance in clinical diagnosis and guiding treatment of gallbladder polypoid lesions.

关 键 词：胆囊息肉样变 超声 M值 

分 类 号：R575.6[医药卫生—消化系统]