黄色肉芽肿性胆囊炎与胆囊癌的病理及免疫组化分析

The Pathologic and Immunohistochemical Study of Xanthogranulomatous Cholecystitis and Gallbladder Cancer

目的 探讨黄色肉芽肿性胆囊炎(XGC)与胆囊癌的病理特点,胆囊粘膜上皮增生、上皮不典型增生和胆囊癌的免疫组化特点.方法 用免疫组化技术(SP法)对6例胆囊上皮不典型增生、8例胆囊癌以及从16例XGC中选出有胆囊粘膜上皮增生者9例,进行PCNA、Ki 67、p53检测.结果 9例XGC中PCNA,Ki 67和p53标记均为阴性;6例上皮不典型增生中Ki 67和p53为阴性,PCNA4例阳性;8例胆囊癌中6例PCNA阳性,5例Ki 67阳性,7例p53阳性.结论 胆囊粘膜上皮增生、不典型增生和胆囊癌的鉴别主要依据组织学特征,PCNA,Ki 67和p53标记对三者的诊断和鉴别诊断有一定的帮助.

OBJECTIVE To evaluate the pathologic characteristics of xanthogranulomatous cholecystitis (XGC) and gallbladder cancer, and the immunohistochemical expressions in the epithelial hyperplasia, atypical hyperplasia and cancer in gallbladder. METHOD 6 cases with epithelial atypical hyperplasia, 8 cases of gallbladder cancer; and 9 cases with epithelial hyperplasia in 16 cases of XGC, using SP immunohistochemical technique to detect the expression of PCNA, Ki-67 and p53. RESULTSIN 9 cases XGC it was nagative in all three gene test; in 6 cases of atypical hyperplasia, 4 cases positive in PCNA, negative in Ki-67 and p53; in 8 cases of gallbladder cancer, 6 cases positive in PCNA, 5 positive in Ki-67 and 7 positive in p53. CONCLUSIONSThe diagnosis of epithelial hyperplasia, atypical hyperplasia and cancer of gallbladder mainly based on histopathological evidence. PCNA, Ki-67 and p53 may be helpful in the diagnoses and differential diagnoses.