原发性胆囊癌16例临床病理分析

目的复习胆囊癌临床病理资料，探讨原发性胆囊癌的病理类型及临床特点。方法收集2002年1月至2007年12月我科胆囊癌16例，对其临床和病理资料进行回顾性分析。结果本组资料16例，男性6例，女性10例，男女比例1：1．7，年龄29。90岁，平均56．5岁。术前临床怀疑癌6例（37．5％），术中及术后意外胆囊癌10例（62．5％），均除外胆囊转移癌。合并结石12例（75％），发生转移4例（25％）。病理组织学分型：腺癌8例（50％），粘液腺癌3例（18．75％），肠型腺癌3例（18．75％），乳头状腺癌1倒（6．25％），腺鳞癌1例（6．25％）。结论胆囊癌的病理类型以腺癌多见，浸润性强，预后差。临床上意外胆囊癌占相当比例，手术医师应提高对胆囊癌的警惕性，有条件者应对可疑病变行术中冰冻切片检查。

Clinicopathological Analysis of 16 Cases with Primary Gallbladder Cancer

Objective To discuss the pathological types and clinical features of primary gallbladder cancer. Methods The clinical and pathological data of 16 cases with gallbladder cancer hospitalized from Jan., 2002 to Dec., 2007 were collected and a retrospective analysis was made. Results Of the 16 cases, the ratio of male and female was 1 ： 1.7, 6 male cases while 10 female cases, the average age was 56.5 years old, from 29 to 90; 6 cases （37.5%） out of the 16 were clinical suspicion of cancer before operation while 10 cases （62.5%） were found to be gallbladder cancer during or after operation, all with the exclusion of cystic metastases; 12 cases （75% ） were complicated with stones, metastasis were found in 4 cases （25 % ） ; the histopathological typing indicated adenocareinoma in 8 cases （ 50 % ）, mucinous adenocarcinoma in 3 cases （ 18.75 % ）, intestinal type adenocarcinoma in 3 cases （ 18.75 % ）, papillate adenocarcinoma in 1 case （6.25%） and adenosquamous carcinoma in 1 case （6.25%） . Conclusions Most gallbladder cancer are pathologically typed to be adenocarcinoma with strong invasion but poor prognosis ; unexpected gallbladder cancer takes up certain percentage in clinic, surgeons should pay more attention, if possible, frozen sections of suspicious affections should be made.