胆结石对胆囊粘膜的病理损害及其与胆囊癌关系的研究

研究结石对胆囊粘膜的病理损害及这一过程中细胞DNA和AgNOR含量的改变,以探讨各型病理改变在胆囊癌发病中的作用。方法:对165例连续切除的胆囊标本进行病理及组化研究。结果:合并结石时胆囊粘膜的单纯增生、不典型增生、胆囊癌发生率分别为75.2％、19.33％和5.4％;结石引起的化生率为38.8％;胆囊粘膜从单纯增生到轻、中、重度不典型增生及胆囊癌的AgNOR颗粒及面积与DNA倍体含量逐步增高;50岁以上结石患者的化生、不典型增生、DNA及AgNOR含量均明显增加。结论:胆囊结石病例的不典型增生明显增多,推测不典型增生是胆囊癌的重要癌前病变,50岁以上的结石患者胆囊癌风险明显增加。

The Pathologic Changes in Gallbladder Mucosa Caused by Gallstone and the Relationship between Gallstone and Carcinoma

To study the pathologic changes in the mucosa of gallbladder mucosa containing stone(s), we determined its DNA and AgNOR protein contents and discuss the role played by the pathologic le-sions in inducing carcinoma. Methods: Histochemical studies were made in 156 cases of gallstones and 9 cases of gallbladder carcinoma with stone(s). Results: The rate of hyperplasia, dysplasia and carcinoma of the gallbladder mucosa were 75.2%, 19.33% and 5.46% respectively. The metaplasia rate of gallbladder mucosa was 38.8%. Conclusions: The DNA and AgNOR protein contents increased from hyperplasia, dys-plasia to carcinoma. The rate of dysplasia and metaplasia as well as the DNA and AgNOR protein cont-ents increased greatly in patients over 50.