胆囊腺瘤癌变的相关因素分析

Analysis of related factors of carcinogenesis of gallbladder adenoma

目的:探讨胆囊腺瘤癌变与临床因素的相关性。方法:应用ROC曲线,计算胆囊腺瘤癌变的肿瘤大小临界值。应用χ~2独立性检验,计算胆囊腺瘤癌变与临床因素的相关性、临床表现与肿瘤位置的相关性。结果:肿瘤良恶性临界值为2.27 cm。胆囊腺瘤癌变与患者的性别、年龄、是否合并结石无明显相关性(P>0.05),而与肿瘤大小、肿瘤数目、形态、超声下是否有血流(P<0.05)等临床病理特征有明显相关性。临床症状与肿瘤是否位于胆囊颈部有明显相关性(P<0.05)。结论:胆囊腺瘤在超声扫描下表现为单发、无蒂、有血流、直径大于2.27 cm,应高度怀疑已有恶变。肿瘤位于胆囊颈部可引起右上腹胀痛、疼痛向右背部放射、恶心呕吐等临床表现。

Objective:To investigate the relationship between carcinogenesis of gallbladder adenoma and clinical factors.Methods:The critical value of tumor size in carcinogenesis of gallbladder adenoma was calculated by ROC curve.χ~2 independence test was used to calculate the correlation between carcinogenesis of gallbladder adenoma and clinical factors,and the correlation between clinical manifestation and tumor location.Results:The critical value of benign and malignant tumor was 2.27 cm.There was no significant correlation between carcinogenesis of gallbladder adenoma and gender,age and stone(P>0.05),but there was a significant correlation with tumor size,tumor number,shape and blood flow under ultrasound(P<0.05).There was a significant correlation between the clinical symptoms and whether the tumor was located in the neck of the gallbladder(P<0.05).Conclusion:Our findings indicate that cholecystic adenoma manifested as single,blood flow,diameter more than 2.27 cm without pedicle,should be highly suspected of malignant change.Tumor located in the neck of the gallbladder can cause right upper abdomen pain,pain to the right back,nausea and vomiting.