胆囊息肉样病变72例临床病理探究

Clinicopathological research for 72 cases of polypoid lesion of the gallbladder

目的 探讨胆囊息肉样病变 (PLG)的临床及病理学特征与恶性病变的关系。方法 分析统计72例PLG临床特征。光镜观察胆囊粘膜上皮异型性增生 ,及与临床特征的关系。结果 (1)单发病灶在恶性病变中占 71% (5 /7) ;在炎性息肉 ,腺瘤样增生及胆固醇息肉中占 14 .8% (8/5 4)。 (2 )直径 >10mm的病灶在恶性病变中占 5 8% (7/12 ) ,直径 <10mm的病灶恶变率为 0。 (3)光镜观察发现 72例中胆囊粘膜上皮增生及不典型增生 ,肠上皮化生占 2 3.6 % (12 /72 )。合并结石的 2 6例PLG中 ,上皮轻度至中度不典型增生占 4 6 % (12 /2 6 )。结论 PLG中息肉单发 ,直径 >10mm恶变率明显增高 ,合并结石 。

Objective It is to investigate the relationship between clinicopathological features of polypoid lesion of the gallbladder (PLG) and its malignant variance.Methods The clinical characters was analysed and the statistics made out of 72 cases of PLG. The cholecystic mucosal epithelial heterotypic hyperplasia were observed by optical microscope, the correlation of its incidence in various polypi and its clinical manifestation also researched.Results (1) The single focus in the maligmant variance was 71%(5/7),but in the imflammatory polyp, adenomatoid hyperplasia and cholesterol polyp was 14.8%(8/54 ).(2) The focal diameter >10mm in malignancy was 58%(7/12),however the focal diameter <10mm of which the malignant rate was Zero.(3) The light\|microscopic observation found the cholecystic mucosal epithelial hyperplasia and atypical hyperplasia or intestinal epithelial metaplasia was 23.6%(12/72) . the PLG complicated calculus was 46%(12/26) had epithelial low to mid\|grade atypical hyperplasia.Conclusion the single polyp, diameter >10mm of the PLG evidently increased oncogenous rate. The PLG complicated calculus and atypical gyperplasia was a high\|risk for malignant variance.