430例胆囊癌临床流行病学调查分析

Clinical epidemiology of 430 cases with gallbladder cancer.

对２８家医院１９８６～１９９６年间的４３０例胆囊癌行回顾性分析。结果：（１）胆囊癌老年女性多见。（２）胆囊癌占同期胆道疾病的１．６％，并存胆结石发生率５０％。（３）临床表现为上腹痛、恶心、黄疸等。（４）以胆囊腺癌为主，填满型胆囊癌最多（５８％）。（５）胆管转移（６８．５％）和肝脏转移（３０％）是主要转移方式。（６）Ｂ超和ＣＴ阳性诊断率分别为７７％和６６％，近５年其对早、中期胆囊癌的术前诊断率显著提高（Ｐ＜０．０５）。（７）Ⅰ、Ⅱ期胆囊癌手术切除率１００％，Ⅲ、Ⅳ期７５％，Ⅴ期显著降低（Ｐ＜０．０５）。（８）Ⅰ、Ⅱ期胆囊癌手术后３年生存率显著高于中晚期（Ｐ＜０．０５）。

Objective:in order to make clear the incidence,clinical charactesis and the possible regional difference of gallbladder cancer in china.Methods:we analyse retropectively 430 cases of gallbladder cancer from 28 hospitals between 1986￣1996.Results:(1)The incidence in female patients is higher than in males.There is significant difference between the North and South,mountain area and flatlands(P<0 05).(2)The incidence of gallbladder cancer account for 1 6% of bile tract disease in the same period.And gallbladder cancer with gall stones is about 50%.(3)Clinical syndrome include abdominal pain,ictus et al.(4)Most of the pathohistology is adenocarcinoma,and the main location is filled in all gallbladder(58%).(5)Along biliary tract or direct into the bed of gallbladder and liver is the main mantastesis way.(6)The positive diagenosis rate of BUS and CT are 77% and 66%.In resent year the positive diagenotic rate is higher than in the past years(P<0 05).(7)The operative excisionsrate in Ⅰ,Ⅱstage is 100%,in Ⅲ,Ⅳ stage is 75%,and in Ⅴ stage is significant lower(P<0 05).(8)3 year existsrate in Ⅰ,Ⅱ stage is significant higher than in terminal cancer(P<0 05).