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与原发性硬化性胆管炎和溃疡性结肠炎相关的早期胆囊癌。

Early gallbladder carcinoma associated with primary sclerosing cholangitis and ulcerative colitis.

作者信息

Yamamoto Takatsugu, Uki Kiyoko, Takeuchi Kazuo, Nagashima Natsuko, Honjo Hajime, Sakurai Norio, Okuda Chikao, Watanabe Goro, Mori Masaya, Kuyama Yasushi

机构信息

Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.

出版信息

J Gastroenterol. 2003;38(7):704-6. doi: 10.1007/s00535-002-1126-z.

Abstract

Patients troubled with primary sclerosing cholangitis (PSC) and ulcerative colitis (UC) are at high risk for cholangiocarcinoma, whereas cancer of the gallbladder (GBC) is rarely reported to develop in that population. A Japanese man aged 62 years with a 14-year history of PSC and UC had been found to have a protruding lesion of the gallbladder by screening sonography. The preoperative examination suggested the lesion to be GBC at an early stage. Pathology examination after cholecystectomy proved that the lesion was papillary adenocarcinoma localized in the mucosal layer. Although the prognosis of GBC is poor, the outcome of cholecystectomy against early GBC is relatively good. Early detection of the tumor is required for a better prognosis of patients with GBC. According to the review of the literature, PSC and UC patients are regarded as a high-risk group not only for cholangiocarcinoma but also GBC. It is advocated that clinicians perform repeated radiographic examinations including sonography for patients with PSC and UC even if the diseases are being controlled.

摘要

患有原发性硬化性胆管炎(PSC)和溃疡性结肠炎(UC)的患者患胆管癌的风险很高,而胆囊癌(GBC)在该人群中很少被报道发生。一名62岁的日本男性,有14年的PSC和UC病史,通过超声筛查发现胆囊有一个突出病变。术前检查提示该病变为早期GBC。胆囊切除术后的病理检查证实该病变为局限于黏膜层的乳头状腺癌。虽然GBC的预后很差,但针对早期GBC进行胆囊切除术的结果相对较好。为了GBC患者有更好的预后,需要早期发现肿瘤。根据文献回顾,PSC和UC患者不仅被视为胆管癌的高危人群,也是GBC的高危人群。主张临床医生即使在疾病得到控制的情况下,也应对PSC和UC患者进行包括超声检查在内的反复影像学检查。

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