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目的 总结全国 2 8个省市自治区的 392 2例胆囊癌临床流行病学调查 (1986～ 1998年 )的结果。 方法 分析了我国胆囊癌和胆囊结石的关系 ,胆囊结石大小和胆囊癌的关系 ,胆结石的病程 ,以及胆囊腺瘤和胆道蛔虫病和胆囊癌的关系。 结果 (1)我国胆囊癌占同期胆道疾病的构成比 0 4%～ 3 8% ,平均为 1 5 3% ,胆囊癌在同期普通外科疾病的构成比为 0 1%～ 1 1% ,平均为 0 2 8%。 (2 )胆囊癌合并胆结石的发生率为 46 7% ,胆囊癌伴发胆囊结石的相对危险度为 13 7。 (3)合并胆结石的病程平均为 10～ 15年。 (4 )合并胆结石的直径平均大于 3cm。 (5 )胆囊腺瘤的恶变率为1 5 %。 (6 )本组仅 4例合并有胆道蛔虫病。 结论 胆囊癌和胆结石的关系密切 ,直径大于 3cm ,病程达 10～ 15年的胆结石应高度提高警惕。胆囊腺瘤和胆囊腺癌密切相关 ,本组资料没有显示胆囊癌和胆道蛔虫病的关系。
Objective To summarize the results of the clinical epidemiological investigation of gallbladder cancer (392 to 198 cases) in 28 provinces, municipalities and autonomous regions across the country. Methods The relationship between gallbladder carcinoma and gallbladder stones in our country was analyzed. The relationship between the size of gallstones and gallbladder cancer, the course of gallstones, and the relationship between gallbladder adenomas and biliary tsutsugamushi disease and gallbladder cancer. Results (1) The proportion of gallbladder cancer in our country accounted for the constitution ratio of biliary tract disease at the same period of 0 4% to 3 8%, with an average of 153%. The gallbladder cancer at the same period consisted of 0 1% to 1 1% of common surgical diseases, with an average of 0 2 8%. (2) The incidence of gallbladder carcinoma with gallstones was 46.7%, and the relative risk of gallbladder cancer with gallstones was 13 7. (3) The average duration of gallstone disease is 10 to 15 years. (4) The average gallstone diameter is greater than 3cm. (5) The malignant rate of gallbladder adenoma was 15%. (6) Only 4 cases of this group were associated with biliary ascariasis. Conclusion Gallbladder cancer is closely related to gallstones. Gallstones with a diameter greater than 3cm and a disease course of 10 to 15 years should be highly vigilant. Gallbladder adenoma and gallbladder adenocarcinoma are closely related. The data in this group did not show the relationship between gallbladder cancer and biliary ascariasis.