胆囊息肉样病变338例临床病理分析

Clinical pathological analysis on 338 cases of polypoid lessions of the gallbladder

目的探讨胆囊息肉样病变（ＰＬＧ）的临床和病理的关系，及指导临床诊治的价值。方法对３３８例手术切除的ＰＬＧ的临床、影像学、病理学的资料进行统计分析。结果３３８例ＰＬＧ占同期胆囊切除数的１０．５％，非肿瘤性息肉为３１１例（９２％）；肿瘤性息肉为２７例（８％），肿瘤性息肉倾向于大于１０ｍｍ并多为单发病灶。５例胆囊癌中有３例为腺瘤癌变者。结论胆囊腺瘤有癌变倾向；凡单发大于１０ｍｍ的病变宜手术切除；年龄可作为肿瘤危险指标之一；

Objective:To investigate the relation between clinical and pathological aspect of polypoid lesions of the gallbladder(PLG),and its profile in directing clinical management.Method:Statistic analysis was performed for the clinical,radiological,ultrasound and pathological data obtained form 338 cases of resected PLG. Result:338 cases of polypoid lesions amounted to 10.5% of the patients undergoing cholycystecomy of the time.Among them were 311(92%) cases of non-neoplasm nature and 27(8%) neoplasm.There were 5 cases of malignant tumors(including 3 cases of adenoma with malignant change).In senile patient,the incidence of polyp of neoplasm nature was significantly higher than that of non-neoplasm polyp.Tumorous polyp tended to be single and more than 10mm in diameter.Conclusion:Adenoma of the gallbladder had the inclination of going malignant change.It was recommended that single lesions with a diameter of more than 10 mm be surgically removed as soon as possible could.Age was a risk factor of tumor of the gallbladder.Importance should be attached to the periodic follow-up foemid-aged patients with PLG.