胆囊癌的诊断

Diagnosis of Cholecystic Carcinoma

经病理确诊的原发性胆囊癌54例,就其影像学所见、肿瘤标志物的阳性率、胆汁细胞学诊断、病理组织学诊断进行分析。术前内窥镜B超、B超、CT检查以胆囊壁肥厚为最多见,一旦伴有息肉或肿瘤就基本可以确诊。血管造影半数病例可见血管伸展、肿瘤血管。ERCP 58%胆囊不显影,但对进一步了解胆管受压、癌肿浸润程度和进行胆汁细胞学检查有意义。影像学诊断中B超诊断率最高(83.3%),ERCP最低(47.2%)。血清肿瘤标志物的阳性率,CA_(19—19)最高为81.3%,CEA为54.1%。胆汁细胞学诊断的阳性率为67.9%。

Fifty-four cases of primary cholecystic carcinoma diagnosed by pathohistological examination were all adenocarcinoma. All the cases had undergone imagological,bile cytological and tumor marker examination preoperatively. B-ultrasound (US), endoscopic B-ultrasound (EUS) and CT revealed hypertrophy of gallbladder wall and the diagnosis could be established once accompanied by polyp or tumor. Among the imagological diagnosis, the US diagnostic rate was the highest (83.3%) and ERCP the lowest (47.2%). Among the tumor markers, CA_(19-9) diagnostic rate was the highest (81.3%). while CEA is less (54.1%) and the bile cytological diagnostic rate was 67.9%.