胆囊息肉样病变的动态监测(附89例分析)

目的　探讨胆囊息肉样病变 (PLG)临床和病理的关系及动态变化 ,提出癌变的高危因素。方法　分析 89例手术切除的PLG的临床和病理资料。结果　 89例PLG占同期胆囊切除的 5 .5 % ,非肿瘤性息肉为 80例(89.9% ) ,合并胆囊结石者占 30 .0 %。肿瘤性息肉为 9例 (1 0 .1 % ) ,其中合并胆囊结石者占 66 .7%。胆固醇息肉占非肿瘤性息肉的 85 % ,肿瘤性息肉多为接近 1 0mm的单发病灶 ,3例胆囊癌中 2例为腺瘤癌变。结论　 >1 0mm的单个PLG、短期内迅速增大的PLG、年龄较大或合并胆囊结石者应手术治疗 ;胆囊腺瘤癌变率较高 ,应尽早手术治疗。加强PLG的动态临床观察。

ANALYSIS OF 89 CASES OF POLYPOID LESIONS OF THE GALLBLADDER

Objective To analyze clinical features of polypoid lesions of the gallbladder (PLG) . Method Clinical and pathological data of 89 cases of resected PLG were analyzed retrospectively. Results 89.9% cases had of nonneoplasm nature ( 30.0% were complicated with gallbladder stone). 10.1% neoplasm ( 66.7% were complicated with gallbladder stone). Cholesterol polypoid was the most common in the pathological types, accounting for 85% of nonneoplasm nature. Malignant polypoid trended to be single and about 10 mm in diameter. There were 3 cases of malignant tumors (including 2 cases of adenoma with malignant change among them). Conclusion Single PLG about 10 mm in diameter and the PLG of rapid growing in short time and the PLG in elderly or complicated with gallbladder stone should be undergoing surgical procedures as soon as possible.