胆囊腺鳞癌和鳞癌与胆囊腺癌的临床对比研究

Adenosquamous and squamous cell carcinoma of the gallbladder

目的探讨胆囊腺鳞癌和鳞癌的临床特点。方法回顾性分析112例胆囊癌患者的临床资料，将其中11例胆囊腺鳞癌和鳞癌的临床特点和预后与同期收治的101例胆囊腺癌进行比较。结果腺鳞癌／鳞癌组与腺癌组的肿瘤浸润分期为r乃或T4的比例分别为100％和53％，两组的差异有统计学意义（X^2=7．013，P=0．008）。腺鳞癌／鳞癌与进展期腺癌（T3或T4期）的远处转移发生率分别为0和35％，差异有统计学意义（X^2=3．900，P=0．048），两组的淋巴结转移率为82％和87％（X^2=0．000，P=1．000）。腺鳞癌／鳞癌组和进展期的腺癌组的胃肠道侵犯发生率分别为45％和15％，差异无统计学意义（X^2=3．618，P=0．054）。两组的中位生存期分别为5个月和4个月，生存差异无统计学意义（X^2=0．359，P=0．549）。结论胆囊腺鳞癌和鳞癌的局部侵袭性强，而远处转移率低。淋巴结转移情况与腺癌相似。

Objective To explore the clinical features of adenosquamous carcinoma, squamous cell carcinoma and adenocarcinoma of the gallbladder. Methods A retrospective analysis of 112 patients with gallbladder carcinoma was performed. The clinical features and outcomes of l l patients with either adenosquamous or squamous cell carcinoma were compared with the other 101 patients of adenocarcinoma. Results The rate of tumor with T3 or T4 stage in adenosquamous/squamous cell carcinoma group and adenocarcinoma group were 100% and 53% （ X^2 = 7. 013, P = 0. 008）. The rate of distant metastasis in adenosquamous/squamous cell carcinoma group and adenocarcinoma at advanced stage （T3 or T4 stage ） group were 0 and 35% （ X^2 = 3. 900, P = 0. 048 ）. The rate of lymph node invasion were 82% and 87% （ X^2 = 0. 000, P = 1. 000 ）. The rate of gastrointestinal tract invasion in adenosquamous/squamous cell carcinoma group and adenocarcinoma at advanced stage （T3 or T4 stage ） group were 45% and 15% （ X^2 = 3. 618,P =0. 054）. The median survival time for the two groups were 5 months and 4 months respectively （ X^2 = 0. 359,P = 0. 549 ）. Conclusions Adenosquamons/squamous cell carcinoma of the gallbladder had high local invasion capacity and usually were diagnosed at an advanced stage. The distant metastasis rate of adenosquamous/squamous cell carcinoma of the gallbladder was lower compared with adenoearcinoma. The lymph node invasion rate of adenosquamous/squamous cell carcinoma was similar to adenocarcinoma.