56例胆囊癌的预后因素分析

Prognostic analysis of patients suffering from gallbladder carcinoma

目的研究影响胆囊癌预后的因素 ,探讨提高胆囊癌疗效的途径。方法回顾性分析1 995年 6月至 2 0 0 1年 6月收治的 56例胆囊癌的临床资料。结果 56例中男 2 0例 ,女 36例 ,其中 34例 (61 % )合并胆结石。腹痛 (47/ 56 ,占 84% )和黄疸 (2 3/ 56 ,占 41 % )是主要临床症状。B超、CT、CA1 9 9有助于术前诊断。 30例 (包括NevinⅡ 5例 ,Ⅲ 3例 ,Ⅳ 4例 ,Ⅴ 1 8例 )获得根治性切除或扩大根治性切除 ,1 1例NevinⅤ期予以姑息性切除 ,剖腹探查行改善症状的各种引流术或 /和活检术 1 5例。统计学分析显示 ,生存时间与手术方式、Nevin分期、放疗、化疗、是否合并胆囊结石 5个因素呈显著相关。结论提高胆囊癌的早期诊断率 ,积极施行根治性切除术 ,辅以放疗、化疗 。

To study parameters influencing the prognosis of patients suffering from gallbladder carcinoma.MethodsA retrospective clinical analysis was made on 56 cases of gallbladder carcinoma, admitted to our hospital between 1995～2001.ResultsThere were 20 males and 36 femals. Thirty four patients(61%) complicated with gallstons.Abdominal pain(47/56,84%) and jaundice(23/56,41%) were the major complaints.Ultrasonography,CT scan and CA 19 9 measurement were helpful for preoperative diagnosis. Thirty cases(including 5 Nevin stage Ⅱ cases,3 stage Ⅲ cases,4 stage Ⅳ cases,and 18 stage Ⅴ cases) received radical or extended radical chelecystectomy, 11 cases with Nevin stage Ⅴ underwent palliative resection and 15 cases of Nevin stage Ⅴ were subjected to bypass procedure and/ or biopsy.The statistical analysis showed staging of Nevin,surgical procedure,gallstone,adjuvant radiotherapy and chemotherapy significantly affected the survival.Conclusions Early diagnosis, radical resection, active and comprehensive adjuvant radiotherapy with/or chemotherapy help to improve the prognosis of gallbladder carcinoma.