论文部分内容阅读
目的分析上海地区胆囊癌的诊治现状。方法对1997年6月至2001年5月间上海市390例确诊胆囊癌的病例进行临床病理分析。结果390例胆囊癌中男108例、女282例,平均年龄64岁,发病率随年龄的增加而上升。有261例(66·9%)合并胆囊结石。主要临床表现为中上腹不适(88·0%)、食欲减退(61·5%)、体重下降(44·4%)。行单纯胆囊切除术187例(56·0%)、胆囊癌根治性切除术65例(19·5%)、胆囊癌扩大根治性切除术7例(2·1%)、剖腹探查术74例(22·2%)。322例获得病理诊断,腺癌为226例(70·2%)最为多见。0~Ⅳb期的5年生存率分别是100%、58·7%、40·2%、9·2%、13·5%和7·1%,根治性切除、胆囊切除和未切除者的5年生存率分别是40·7%、31·3%和2·6%(P<0·01)。结论提高胆囊癌的早期诊断率,规范胆囊癌的治疗方法是提高疗效的关键。
Objective To analyze the diagnosis and treatment of gallbladder cancer in Shanghai. Methods A total of 390 cases of gallbladder carcinoma diagnosed in Shanghai from June 1997 to May 2001 were analyzed clinically and pathologically. Results Of 390 cases of gallbladder cancer in 108 males and 282 females, with an average age of 64 years old, the incidence increased with age. There were 261 cases (66.9%) with gallstone. The main clinical manifestations were middle and upper abdominal discomfort (88.0%), loss of appetite (61.5%) and weight loss (44.4%). There were 187 cases (56.0%) with simple cholecystectomy, 65 cases (19.5%) with radical resection of gallbladder carcinoma, 7 cases (2.1%) with radical resection of gallbladder carcinoma and 74 cases with laparotomy (22.2%). 322 cases were pathologically diagnosed, adenocarcinoma 226 cases (70.2%) the most common. The 5-year survival rates from 0 to IVb were 100%, 58.7%, 40.2%, 9.2%, 13.5% and 7.1% respectively. The 5-year survival rates of patients who underwent radical resection, cholecystectomy and resection The 5-year survival rates were 40.7%, 31.3% and 2.6%, respectively (P <0.01). Conclusions To improve the early diagnosis rate of gallbladder cancer and standardize the treatment of gallbladder cancer is the key to improve the curative effect.