Roa Iván, Ibacache Gilda, Roa Juan, Araya Juan, de Aretxabala Xabier, Muñoz Sergio
Department of Pathology, Faculty of Medicine Universidad de la Frontera, Temuco, Chile.
J Surg Oncol. 2006 Jun 15;93(8):624-8. doi: 10.1002/jso.20528.
Gallstones are considered the most important risk factor for gallbladder cancer.
To identify differences in the number, weight, volume, and density of gallstones associated with chronic cholecystitis (CC), gallbladder dysplasia (GD), and gallbladder cancer (GBC).
A total of 125 cases were selected, of which 93 had gallstones associated with GBC and 31 had gallstones associated with GD. The controls were those with CC, matched by sex and age. The number, weight, volume, and density of these gallstones were examined in order to determine differences and relative cancer risk.
Number: Multiple gallstones were present in over 76% of cases (GBC and GD) and controls (P = ns). The average number of multiple stones was 21 in GBC versus 14 in controls (P < 0.01). Weight: The average weight of the gallstones was 9.6 g in GBC versus 6.0 g in controls (P = 0.0004). The average weight in multiple stones over 10 g had strong association with GBC (P = 0.0006). Volume: The average volume was 11.7 and 6.48 ml in GBC and controls (P = 0.0002). Average volumes of 6, 8, and 10 ml had a relative cancer risk of 5, 7, and 11 times, respectively. Size: No differences were shown between GBC, GD, and controls.
The volume of gallstones associated with other risk factors of GBC may be helpful in prioritizing cholecystectomies in symptomatic patients.
胆结石被认为是胆囊癌最重要的危险因素。
确定与慢性胆囊炎（CC）、胆囊发育异常（GD）和胆囊癌（GBC）相关的胆结石在数量、重量、体积和密度上的差异。
共选取125例病例，其中93例患有与GBC相关的胆结石，31例患有与GD相关的胆结石。对照组为CC患者，按性别和年龄匹配。检查这些胆结石的数量、重量、体积和密度，以确定差异和相对癌症风险。
数量：超过76%的病例（GBC和GD）及对照组存在多发胆结石（P = 无显著性差异）。GBC组多发结石的平均数量为21个，而对照组为14个（P < 0.01）。重量：GBC组胆结石的平均重量为9.6 g，而对照组为6.0 g（P = 0.0004）。重量超过10 g的多发结石的平均重量与GBC有很强的相关性（P = 0.0006）。体积：GBC组和对照组的平均体积分别为11.7和6.48 ml（P = 0.0002）。平均体积为6、8和10 ml时，相对癌症风险分别为5倍、7倍和11倍。大小：GBC、GD和对照组之间未显示出差异。
与GBC其他危险因素相关的胆结石体积可能有助于对有症状患者的胆囊切除术进行优先排序。
