摘要
目的探讨老年患者胆囊炎胆囊结石合并胆囊癌的发病特点,提高胆囊癌预防和治疗效果。方法回顾北京军区总医院肝胆外科1997年1月—2010年5月老年患者胆囊炎胆囊结石合并胆囊癌29例(胆囊癌组),选择同期单纯胆囊炎胆囊结石手术患者25例作为对照组。从年龄、病程、体质量减轻和癌抗原19-9检测数据、结石类型、黄疸、腹痛、发热、上腹涨满、胆囊萎缩和胆囊壁增厚及标本的病理等方面进行数据分析。结果与对照组比较,胆囊癌组病程延长[(11±3.1)年vs(3±1.2)年],体质量减轻明显[(12±2.4)kgvs(3±0.5)kg],癌抗原19-9明显增高[(322±102)ng/mlvs(52±2)ng/ml],黄疸(37.9%vs12.0%)、胆囊萎缩(44.8%vs12.0%)、胆囊壁增厚(51.7%vs32.0%)的发生率明显高,腹痛症状发生率(31.0%vs92.0%)明显低,差异均有统计学意义(P<0.05,P<0.01)。术前CT及B超检查对诊断胆囊占位有明显作用。术后病理显示,肿瘤组瘤旁胆囊黏膜及黏膜下慢性炎症明显,胆囊壁内大量纤维组织增生炎性细胞侵润明显,异型增生和围手术期并发症较对照组明显增多。结论老年患者胆囊炎胆囊结石癌变率高,临床症状不典型,术后并发症多,应早诊断、早治疗。
Objective To study the clinical characteristics of gallbladder cancer accompanied with cholelithiasis in 29 older cases. Methods Retrospectively 29 cases of gallbladder cancer accompanied with cholelithiasis in our department from Jan 1997 to May 2010 （cancer group） were analyzed. And 25 cases with solely cholelithiasis were chosen as control group. Differences in age, sex,duration,weight loss,CA19-9 value,stone style,jaundice,abdominal pain,fever and pathology of gallbladder biopsies from two groups were analyzed. Results Duration of cholelithiasis was much longer in cancer group than in control group [ （11.0±3.1 ）y vs （3.0±1.2） y ], weight loss was significant in cancer group than in control group [ （ 12.0±2.4 ） kg vs （3.0±0.5） kg ], CA 19-9 value in cancer group was higher than in control group [ （ 322 ±102 ） ng/ml vs （52 ±2 ） ng/ml ]. Jaundice （ 11/29 vs 3/25 ）, atrophy of gallbladder （ 13/ 29 vs 3/25） and thick wall of gallbladder （15/29 vs 8/25）were significant in cancer group than in control group ;abdomen pain was significant in control group than in cancer group. CT and type B Echography showed valuable inlbrmation to confirm whether the gall- bladder has the mass or not. All gallbladder biopsies in cancer group were testified adenocarcinoma pathologically. Conclusions The canceration of gallbladder in older cholelithiasis patients were higher than the control group. Clinical symptoms were atypical and have much more complications post operation. Diagnosis and operations should be as early as possible.
出处
《中华保健医学杂志》
2011年第4期318-320,共3页
Chinese Journal of Health Care and Medicine
关键词
胆囊癌
胆囊炎
胆囊结石
Gallbladder cancer
Choleeystitis
Cholelithiasis
