疑似胆管癌手术切除患者的特发性良性胆道狭窄。
Idiopathic benign biliary strictures in surgically resected patients with presumed cholangiocarcinoma.
机构信息
Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
出版信息
HPB (Oxford). 2005;7(4):283-8. doi: 10.1080/13651820500292954.
OBJECTIVE
Distinguishing between malignant and benign biliary strictures remains problematic. The aim of this study was to compare and contrast the clinical features of patients with benign and malignant biliary strictures.
METHODS
Medical records of patients who underwent surgical resection for presumed cholangiocarcinoma were reviewed. Immunohistochemistry for hypoxia inducible factor-1-alpha (HIF-1-alpha) was performed on all bile ductule samples.
RESULTS
Twelve patients with benign strictures (group I) were compared to 26 patients with cholangiocarcinoma (group II). Group I was predominantly female (ratio 2: 1), (p<0.01), whereas the gender ratio was 1: 1 in patients in group II. Bismuth-Corlette type strictures in group I were more likely to be type I/II, whereas type III strictures predominated in group II. The CA 19-9 was <100 U/ml in 6 and >100 U/ml in 1 patient of group I and <100 in 13 and >100 in 11 patients in group II. Half of the patients in group I had positive immunoreactivity for HIF-1-alpha in bile ductules.
CONCLUSION
Benign biliary strictures masquerading as cholangiocarcinomas occur more often in women, are less often Bismuth-Corlette type III, have serum CA 19-9 values <100 U/ml, and hypoxia may play a role in a subset of these strictures.
目的
鉴别良恶性胆道狭窄仍然存在问题。本研究旨在比较和对比良性和恶性胆道狭窄患者的临床特征。
方法
回顾了接受手术切除疑似胆管癌的患者的病历。对所有胆管样本进行缺氧诱导因子-1-α（HIF-1-α）的免疫组织化学检测。
结果
将 12 例良性狭窄患者（I 组）与 26 例胆管癌患者（II 组）进行比较。I 组主要为女性（比例 2:1），（p<0.01），而 II 组患者的性别比例为 1:1。I 组的 Bismuth-Corlette 型狭窄更可能是 I/II 型，而 III 型狭窄在 II 组中更为常见。I 组中有 6 例 CA 19-9<100 U/ml，1 例>100 U/ml，而 II 组中有 13 例 CA 19-9<100 U/ml，11 例>100 U/ml。I 组中有一半的患者胆管内 HIF-1-α的免疫反应阳性。
结论
良性胆道狭窄伪装成胆管癌在女性中更常见，Bismuth-Corlette 型 III 型较少，血清 CA 19-9 值<100 U/ml，缺氧可能在这些狭窄中的一部分中起作用。
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