Stancu Manuela, Căruntu Irina Draga, Giuşcă Simona, Dobrescu Gioconda
Department of Histology, Faculty of Dental Medicine, Gr. T. Popa University of Medicine and Pharmacy, Iassy, Romania.
Rom J Morphol Embryol. 2007;48(4):335-42.
The aim of the study was to analyze the association between chronic cholecystitis, premalignant lesions and gallbladder cancer. The group consisted in 3901 cases of cholecystectomies, diagnosed as acute cholecystitis (250 cases - 6.4%), chronic cholecystitis (3619 cases - 92.8%) and gallbladder carcinoma (32 cases - 0.8%). Chronic cholecystitis associated premalignant lesions as follows: hyperplasia in 124 cases (7.8%), metaplasia in 86 cases (5%) and dysplasia in 10 cases (0.4%). Only in nine cases, the diagnosis of gallbladder carcinoma was formulated presumptively, before surgery; for the other 23 cases this diagnosis was established after the pathologic exam on the cholecystectomy piece. In the areas adjacent to the neoplastic proliferation, premalignant lesions (hyperplasia, metaplasia, dysplasia) were identified in 34.4% cases. The identification of premalignant modifications in the morphologic background of chronic cholecystitis is an argument in favor of the metaplasia-dysplasia-neoplasia sequence and justifies recent recommendations for the performing of colecystectomy.
本研究的目的是分析慢性胆囊炎、癌前病变与胆囊癌之间的关联。该组包括3901例胆囊切除术病例，诊断为急性胆囊炎（250例，占6.4%）、慢性胆囊炎（3619例，占92.8%）和胆囊癌（32例，占0.8%）。慢性胆囊炎合并的癌前病变如下：增生124例（7.8%）、化生86例（5%）和发育异常10例（0.4%）。仅9例在手术前初步诊断为胆囊癌；其他23例在胆囊切除标本病理检查后确诊。在肿瘤增殖邻近区域，34.4%的病例发现有癌前病变（增生、化生、发育异常）。在慢性胆囊炎形态学背景中发现癌前改变支持化生-发育异常-肿瘤形成序列，并证明了近期进行胆囊切除术建议的合理性。
