论文部分内容阅读
目的研究上海市区居民胆道癌病理形态特征和鉴别诊断。方法自1997年6月～2001年5月在上海市区开展基于全人群的胆道癌病例-对照研究,总共收集病理切片1228例,包括胆道癌487例(其中胆囊癌322例,肝外胆管癌105例和壶腹癌60例),胆道结石和胆囊炎对照病例721例,胆道腺瘤20例,由中、美资深病理医师复查,按世界卫生组织1991年胆囊和肝外胆管肿瘤组织学分型进行分类。结果病理标本以切除标本为主,肿瘤大小为多数小于4cm,组织学类型中70％以上为腺癌,肿瘤组织学分级以高分化和中分化占绝大多数,TNM分期中0～Ⅱ期的胆囊癌和肝外胆管癌约占1／3,壶腹癌近2／3。病理复查结果显示诊断过头占1．8％,诊断不足占0．6％,漏诊占0．1％；随访结果显示根治术后的5年生存率：胆囊癌40．7％、肝外胆管癌11．1％和壶腹癌26．9％。结论病理复查可以统一诊断标准,提高确诊率,为全人群病例-对照研究和多学科协作积累经验。
Objective To study the pathological features and differential diagnosis of biliary tract cancer in Shanghai residents. Methods A total population of 1228 cases of cholangiocarcinoma was enrolled in the Shanghai urban area from June 1997 to May 2001. A total of 1228 cases of cholangiocarcinoma were collected, including 487 cases of cholangiocarcinoma (including 322 cases of gallbladder carcinoma, 105 cases and ampulla of 60 cases), 721 cases of biliary calculi and cholecystitis control cases, 20 cases of biliary adenoma, reviewed by senior pathologists in China and the United States, according to the World Health Organization 1991 gallbladder and extrahepatic bile duct tumor histological type sort. Results Most of the specimens were excised. Most of the tumors were less than 4 cm in size. More than 70% of the histological types were adenocarcinoma. The histological grade of the tumors accounted for the vast majority of the differentiated and differentiated tumors. The TNM stages 0 to 2 Gallbladder and extrahepatic bile duct cancer accounts for about 1/3, ampulla nearly 2/3. The results of pathological examination showed that the diagnosis was over 1.8%, the diagnosis was less than 0.6% and the missed diagnosis was 0.1%. The follow-up results showed that the 5-year survival rate after radical operation was 40.7% of gallbladder carcinoma, 11.1% and ampulla 26.9%. Conclusion The pathological examination can unify diagnostic criteria and improve the diagnosis rate, accumulating experience for case-control study and multidisciplinary collaboration in whole population.