胆囊结石患者发生意外胆囊癌的临床分析  

Risk factors of incidental gallbladder cancer in patients with gallstone

作　　者：潘治平 孙旭 岑峰 严强 PAN Zhiping;SUN Xu;CEN Feng;YAN Qiang(Department of General Surgery,Huzhou Central Hospital(Affiliated Huzhou Hospital,Zhejiang University School of Medicine),Huzhou 313000,China;不详)

机构地区：[1]湖州市中心医院(浙江大学医学院附属湖州医院)普通外科,313000

出　　处：《浙江医学》2023年第13期1401-1404,共4页Zhejiang Medical Journal

摘　　要：目的分析胆囊结石患者发生意外胆囊癌的因素。方法收集2016年12月至2022年8月湖州市中心医院患胆囊结石、择期行胆囊切除手术的患者8010例,其中意外胆囊癌患者33例(观察组),按1∶4随机抽取胆囊结石伴胆囊炎患者132例作为对照组。比较两组患者基础指标(包括性别、年龄、BMI、是否合并糖尿病、高血压、胆道结石)以及血液学指标[血清钠(Na+)、尿素氮(BUN)、肌酐(Cr)、白蛋白(ALB)、TBil、DBil、ALT、AST、ALP、WBC、Hb、PLT、国际标准化比值(INR)、PT、D-二聚体(D-D)、糖类抗原19-9(CA19-9)]的差异。结果观察组患者年龄、BMI、合并糖尿病比例均明显高于对照组,差异均有统计学意义(均P<0.05)。观察组患者ALB水平明显低于对照组,AST、ALP、D-D水平及CA19-9异常比例明显高于对照组,差异均有统计学意义(均P<0.05)。结论意外胆囊癌更可能在年龄较大(>65岁)、BMI偏高、合并糖尿病的胆囊结石患者中发生,伴有AST、ALP、D-D、CA19-9水平升高及ALB水平降低。Objective To explore the factors associated with the occurrence of incidental gallbladder cancer(IGBC)in patients with gallstones.Methods A total of 8010 patients with cholecystolithiasis who underwent elective cholecystectomy in Huzhou Central Hospital from December 2016 to August 2022 were enrolled,including 33 cases with incidental gallbladder cancer(study group)and 132 cases randomly selected among gallstone patients with cholecystitis at 1∶4 ratio(control group).The basic indicators(including gender,age,BMI,comorbid diabetes,hypertension and biliary stones),and hematological indicators(Na+,BUN,Cr,ALB,TBil,DBil,ALT,AST,ALP,WBC,Hb,PLT,INR,PT,D-D,CA19-9)were compared between two groups.Results The age,BMI and comorbid diabetes in study group were significantly higher than those in the control group(all P<0.05).The ALB levels of the study group were significantly lower than those of the control group,while the AST,ALP,D-D and CA19-9 levels were significantly higher than those of the control group(all P<0.05).Conclusion Incidental gallbladder cancer is more likely to occur in patients with older age,comorbid diabetes and increased BMI,AST,ALP,D-D,CA19-9 and decreased ALB levels.

关 键 词：胆囊癌 意外胆囊癌 胆囊结石 

分 类 号：R735.8[医药卫生—肿瘤]