胆囊息肉样病变的病理学和影像学特征

Character of lmaging and Histopathology in Polypoid Lesions of Gallbladder

本文对经手术和病理证实的１６２例胆囊息肉样病变进行了分析，其中良性病变１４０例（８６．４２％），恶性病变２２例（１３．５８％）。恶性病变组５９．３５％的患者年龄＞５０岁。病变的９０．９１％为单发性，直径９５．０５％＞１ｃｍ，６３．６４％的病例合并胆结石。乳头状腺瘤，特别是伴有不典型增生的腺瘤、腺肌瘤病具有恶变倾向。Ｂ超及口服胆囊造影的诊断符合率分别是９６．３０％和５５．５６％（Ｐ＜０．００１）。因此，对于直径＞１ｃｍ、单发性、合并胆结石的ＰＬＧ应该手术治疗。而对直径＜１ｃｍ、多发性、有蒂的ＰＬＧ应该Ｂ超定期复查、短期内病变有增大者，也应及时手术切除。

One bandred and sixty two patients with polypoid lesions of the gallbladder (PLG)proved by operation and histopathology from june l986 to january 1993 were studied,of the 162cases, 140 (86.42)were benign, 22 (l3.58%)were malignant. Single lesions accounted for90.91% of malignant lesions. 95.05% of carcinoma were more than 1 cm in diamater P<001.There were 63.64%of malignant lesions coexisted with gallstones. The adenomyoma, papillomaand adenoma with atypical hyperplasias have malignant potential. The sensitivity of ultrasonogra- phy(US), oral cholecystography in detecting PLG was 96.30%and 55.56%respeetively. Whenthe PLG exceeds 1 cm in diamate, single in number and associated with gallstones, surgical tre-atment must be considered.