胆囊癌伴胆囊结石的临床特点分析

Analysis of clinical characteristics of gallbladder carcinoma with gallstone

目的评估已接受手术治疗的胆囊癌患者中,胆囊结石的数量和大小对预后价值的影响。方法回顾性收集和研究了2010年5月至2020年12月间接受手术治疗的胆囊癌患者的临床数据。通过门诊和电话跟踪患者的生存状态或死亡情况,随访至2022年5月结束。比较了胆囊结石的大小和数量对生存的影响。结果在此研究中,66名患者的数据完整且能够进行有效的随访,中位随访时间为37.0个月,中位生存时间为14.8个月。患者1年、3年和5年累积生存率分别为60.61%、32.97%和21.98%。单因素分析结果显示,手术类型、肝脏侵犯、TNM分期、肿瘤组织分化程度和浸润深度是影响胆囊癌患者预后的因素(P<0.05)。多因素分析结果显示,手术类型和肿瘤组织分化程度是影响胆囊癌患者预后生存的独立预后因素(P<0.05)。对于合并胆囊结石的43名胆囊癌患者的多因素分析结果显示,手术类型和胆囊结石的大小是影响这些患者预后生存的独立因素(P<0.05)。结论对于早期或晚期肿瘤的患者,进行根治性手术显著提高了他们的生存率。合并胆囊结石的胆囊癌患者中,结石小于1厘米可能预示着更好的预后。

Objective To evaluate the prognostic value of the number and size of gallstones in patients with gallbladder carci-noma(GBC)who have undergone surgery.Methods The clinical data of patients with GBC who underwent surgical treatment be-tween May 2010 and December 2020 were retrospectively collected and studied.Follow-up was conducted by outpatient and telephone to confirm survival or death,and the end of the follow-up was May 2022.The influence of gallstone size and number on survival was compared.Results In this study,66 patients were effectively followed up with complete data.The median follow-up time was 37.0 months,and the median survival time of included patients was 14.8 months.Cumulative survival rates at 1,3,and 5 years were 60.61%,32.97%,and 21.98%.Univariate analysis showed that surgical type,liver invasion,TNM stage,degree of carcinoma dif-ferentiation,and depth of invasion were the prognostic factors of CBC patients(P<0.05).Multivariate analysis showed that surgical type and degree of carcinoma differentiation were independent prognostic factors of GBC.Multivariate survival analysis of 43 cases of GBC with gallstones showed that the surgical type and gallstone size were independent factors influencing the prognosis of patients with GBC.Conclusion Radical surgery significantly improves the prognosis of patients with early or advanced tumors.Among patients with GBC with gallstones,a stone size of less than 1 cm might predict better survival.