摘要
目的探讨胆囊息肉样病变恶性倾向的危险因素、超声造影表现及其在鉴别良、恶性息肉样病变中的应用。方法收集356例胆囊息肉样病变的手术病理与术前超声的资料,回顾性分析其临床和病理特征。结果手术病理结果显示,假瘤样息肉是胆囊息肉的最主要病理类型335例(94.1%),其次为良性腺瘤和恶变息肉,分别是12例(3.4%)和9例(2.5%)。在胆囊息肉恶变组中,年龄>50岁居多(占88.9%),其息肉病理类型以乳头状或乳头管状腺瘤为主(OR=17.5,P<0.01)。随着息肉的增大,恶性率逐渐增加。息肉直径≥2cm时,恶性率≥50.0%。结合手术病理结果分析发现,合并胆囊结石是影响胆囊息肉超声诊断的重要因素,彩色多普勒血流显像(CDFI)指标是预测良恶性息肉的独立因素。结论年龄>50岁、胆囊直径增大以及CDFI指标是胆囊息肉恶性倾向的危险因素。
Objective To explore potential risk factors of malignant gallbladder polypoid lesions, and evaluate the value of ultrasound in differential diagnosis of malignant and benign gallbladder polypoid lesions. Methods 356 cases of gallbladder polypoid lesions were collected and retrospectively analyzed the clinical and pathological features by data of operative pathology and preoperative ultrasonic examination. Results The operative pathological findings revealed that pseudotumor polyps were the most major pathological type （94.1% ） , benign adenomas and malignant polyp of gall- bladder were 12 cases （3.4%） and 9 cases （2.5%） respectively. In malignant group of the gallbladder polyps, the majority （88.9%） of patients was over 50 years old, papillary or tubulopapillary adenoma was the most common poly- poid lesions （ OR = 17.5, P 〈0.01 ）. With the increase of the polyp size, the rate of malignancy was increased. When the polyp size was greater than or equal to 2 em, the malignancy rate was greater than or equal to 50.0%. Preoperative uhrasonie examination revealed complicating gallstone was an important impact factor of ultrasound diagnosis of gallblad- der polyps. Color Doppler flow imaging （CDFI） was an independent predictive factor for differential diagnosis of malig- nant and benign polyps. Conclusion More than 50 years old, increased gallbladder diameters and the CDFI are malig- nant potential risk factors.
出处
《胃肠病学和肝病学杂志》
CAS
2013年第8期815-818,共4页
Chinese Journal of Gastroenterology and Hepatology
关键词
胆囊息肉样病变
病理特征
超声诊断
危险因素
息肉大小
Gallbladder polypoid lesions
Pathological features
Uhrasonographie diagnosis
Risk factors
Size of polyp
