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目的 提高对原发性胆囊癌 (PCC)的认识及诊治水平。方法 对 1979年 5月～ 1998年 9月收治经手术及病理证实的PCC 41例的临床资料进行回顾性分析。结果 PCC患者临床表现缺乏特异性 ,本组术前确诊率仅 5 3 6 %。肿瘤位于胆囊颈部 2 7例 ,体部 3例 ,底部 4例 ,整个胆囊 7例。腺癌2 2例 ,粘液腺癌 7例 ,低分化腺癌 4例 ,腺瘤型息肉癌变 2例 ,腺鳞癌 1例 ,乳头状腺癌 5例。术后对2 4例进行随访 ,15例在术后 1年内死亡 ,生存 2年 5例 ,3年 2例 ,5年 1例 ,已生存 11年 1例。结论 B超和CT两者结合可使原发性胆囊癌诊断率明显提高。胆囊癌的预后与肿瘤侵犯程度、病理类型、手术彻底与否有关。早期诊断 ,早期手术等是改善胆囊癌的疗效及预后的关键
Objective To improve the understanding and diagnosis of primary gallbladder cancer (PCC). Methods The clinical data of 41 cases of PCC treated by surgery and pathology from May 1979 to September 1998 were retrospectively analyzed. Results The clinical manifestations of PCC patients were lack of specificity. The preoperative diagnosis rate in this group was only 536%. Tumors were found in 27 cases of gallbladder neck, 3 in the body, 4 in the bottom, and 7 in the entire gallbladder. There were 22 adenocarcinomas, 7 mucinous adenocarcinomas, 4 poorly differentiated adenocarcinomas, 2 adenomatous polyposis, 1 adenosquamous carcinoma, and 5 papillary adenocarcinomas. Postoperative follow-up of 24 cases, 15 cases died within 1 year after surgery, 5 cases survived 2 years, 2 cases 3 years, 1 case 5 years, 1 case survived 11 years. Conclusion The combination of B-ultrasonography and CT can significantly improve the diagnostic rate of primary gallbladder carcinoma. The prognosis of gallbladder cancer is related to the degree of tumor invasion, pathological type, and whether the operation is complete or not. Early diagnosis and early surgery are the keys to improving the efficacy and prognosis of gallbladder cancer