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随访分析了瑞金医院近14年的原发性胆囊癌87例,其中男30例,女57例,平均年龄64.2岁,58％的病例合并有胆囊结石。最常见的临床表现为右上腹疼痛,黄疸及右上腹包块。B超和CT的确诊率分别为44.9％和47.1％。60例作病理学检查,其中腺癌占88.1％。本组60％以上患者已无法切除病灶,根治性手术占8.1％。总的5年生存率为3.7％。早期肿瘤和分化好的肿瘤生存期较长。手术切除能明显改善预后。“早期”胆囊癌行胆囊床切除和淋巴结清扫,晚期肿瘤行根治术后可提高生存率。结果提示:胆囊癌的病理,诊断和治疗均与预后有关。
Follow-up analysis of 87 cases of primary gallbladder carcinoma in Ruijin Hospital in the past 14 years, including 30 males and 57 females, with an average age of 64.2 years, 58% of cases had gallstones. The most common clinical manifestations are pain in the right upper quadrant, jaundice and right upper quadrant mass. The diagnostic rates of B-mode ultrasound and CT were 44.9% and 47.1%, respectively. Sixty patients underwent pathological examination, of which adenocarcinoma accounted for 88.1%. More than 60% of patients in this group have been unable to remove the lesion, radical surgery accounted for 8.1%. The overall 5-year survival rate was 3.7%. Early tumors and well-differentiated tumors have a longer survival period. Surgical resection can significantly improve the prognosis. “Early” gallbladder carcinoma undergoes gallbladder axotomy and lymph node dissection. Advanced radical surgery can improve survival. The results suggest that the pathology, diagnosis and treatment of gallbladder carcinoma are related to prognosis.