原发性胆囊癌104例临床误诊分析

目的分析原发性胆囊癌临床误诊原因并讨论防止临床误诊的措施。方法回顾性分析104例原发性胆囊癌患者术前误诊的临床资料、病理诊断和实验室检查结果。结果 104例原发性胆囊癌患者术前误诊为良性疾病(胆囊结石、急性胆囊炎和胆囊息肉)68例(65.4%),误诊为恶性疾病(肝癌、胰腺癌和胆管癌)36例(34.6%),误诊为良性疾病和恶性疾病的构成比比较差异有统计学意义(P<0.01)。年龄50～59岁与60～69岁构成比比较差异无统计学意义(P>0.05),但年龄≤49岁(11.5%)与≥50岁(88.5%)构成比比较差异有统计学意义(P<0.01)。胆囊壁厚度≤0.9 cm(25.0%)与≥1.0 cm(75.0%)构成比比较差异有统计学意义(P<0.01)。结论临床诊断胆囊结石或急性胆囊炎时应排除原发性胆囊癌,以降低原发性胆囊癌的误诊率。

Clinical misdiagnosis analysis in 104 patients with primary gallbladder carcinoma

Objective To analyze the clinical misdiagnosis of primary gallbladder carcinoma and to explore the effective measures to prevent misdiagnosis.Methods The clinical data,pathological diagnosis and the result of laboratory in 104 patients with primary gallbladder carcinoma were retrospective analyzed.Results In 104 patients with primary gallbladder carcinoma,68 cases(65.4%) were misdiagnosed as benign disease(cholecyslithiasis,acute cholecystitis and gallbladder polyps),36 cases(34.6%) were misdiagnosed as malignant disease(liver cancer,pancreatic cancer and bile duct carcinoma).There was statistical significance between constituent ratios of misdiagnosed as benign disease and malignant disease(P<0.01).There was no statistical significance between the constituent ratios of 50-59 years old and 60-69 years old(P>0.05),but there was statistical significance between the constituent ratios of ≤49 years old(11.5%) and ≥50 years old(88.5%)(P<0.01).There was statistical significance between the constituent ratios of gallbladder wall thickness ≤0.9 cm(25.0%) and ≥1.0 cm(75.0%)(P<0.01).Conclusion The results show that the gallbladder carcinoma should be excluded in clinical diagnosis of gallbladder stones or acute cholecystitis for reducing the misdiagnosis rate of gallbladder cancer.