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目的分析胆囊癌的临床特点,探讨早期诊断的相关指标,提高早期诊断率,最终达到改善预后。方法收集在河北医科大学第二医院治疗的胆囊癌患者80例,以胆囊结石及胆囊息肉患者90例作为对照,对2组进行组间比较及单、多因素Logistic回归分析。结果 2组间在患病年龄、腹胀纳差、胆囊占位、胆囊壁厚、肝门区肿大淋巴结、肝内外胆管扩张间存在差异;在实验室检查方面糖类抗原19-9(carbohydrate atigen 19-9,CA19-9)、糖类抗原125(carbohydrate atigen 125,CA125)、糖类抗原50(carbohydrate atigen 50,CA50)、血红蛋白(hemoglobin,HGB)、总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、间接胆红素(indirect bilirubin,IBIL)、丙氨酸转氨酶(alanine transaminase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、碱性磷酸酶(alkaline phosphate,ALP)、γ-谷氨酰转移酶(γ-glutamyl transpeptidase,γGGT)、总胆汁酸(total bile acid,TBA)存在差异。结论原发性胆囊癌的起病隐匿、临床表现无特异性,综合超声、CT、实验室检查可提高胆囊癌术前诊断率。控制胆囊癌的高危因素能有效预防胆囊癌的发生,从而改善预后。对于胆囊癌高危人群的早期筛查是胆囊癌临床治疗的关键。胆囊癌的临床分期对胆囊癌的预后影响大。提高胆囊癌早诊率是提高胆囊癌治疗水平的关键。
Objective To analyze the clinical features of gallbladder cancer, to explore the relevant indicators of early diagnosis, improve the early diagnosis rate, and ultimately to improve the prognosis. Methods Totally 80 gallbladder cancer patients were treated in the Second Hospital of Hebei Medical University. Ninety patients with cholecystolithiasis and gallbladder polyps were used as controls. The two groups were compared between groups by single factor and multivariate logistic regression analysis. Results There were differences between the two groups in terms of age of sickness, abdominal distension and anorexia, gallbladder occupancy, gallbladder wall thickness, swollen lymph nodes in the hilar region, and intrahepatic and extrahepatic bile duct dilatation. In laboratory tests, carbohydrate atigen 19-9, CA19-9), carbohydrate atigen 125 (CA125), carbohydrate atigen 50 (CA50), hemoglobin (HGB), total bilirubin (TBIL) , Direct bilirubin (DBIL), indirect bilirubin (IBIL), alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase alkaline phosphatase (ALP), γ-glutamyl transpeptidase (γGGT) and total bile acid (TBA). Conclusion The onset of gallbladder cancer is insidious and the clinical manifestations are nonspecific. Comprehensive ultrasound, CT and laboratory tests can improve the preoperative diagnosis rate of gallbladder cancer. Control of risk factors for gallbladder cancer can effectively prevent the occurrence of gallbladder cancer, thereby improving the prognosis. Early screening for high-risk populations of gallbladder cancer is the key to the clinical treatment of gallbladder cancer. The clinical stage of gallbladder cancer has a great influence on the prognosis of gallbladder cancer. To improve the diagnosis rate of gallbladder cancer is the key to improve the treatment of gallbladder cancer.