Lee Seung Ho, Lee Dal Sik, You Il Young, Jeon Won Joong, Park Seon Mee, Youn Sei Jin, Choi Jae Woon, Sung Rohyun
Departments of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Korea.
Korean J Gastroenterol. 2010 Feb;55(2):119-26. doi: 10.4166/kjg.2010.55.2.119.
BACKGROUND/AIMS: In order to determine the malignant potential of gallbladder adenoma for progression to carcinoma, we evaluated the histopathologic features of adenoma and adenoma-related lesions on cholecystectomized specimens.
Among 1,847 cholecystectomized specimens, 63 specimens from 26 benign adenomas, 9 carcinomas in situ (CIS), and 28 invasive carcinomas were selected. A pathologist reviewed all specimens and selected benign adenomas, CIS in the adenoma, and adenoma residue in invasive carcinomas. Adenomas and adenoma-related lesions were classified according to morphology (tubular, tubulopapillary, and papillary) and the consisting epithelium (biliary, pyloric metaplasia, and intestinal metaplasia). The age and the size of the benign adenomas and carcinomas in the adenoma were also compared.
Adenoma and adenoma-related lesions were found in 34 out (1.8%) of all resected gallbladder. Among 9 CIS and 28 invasive carcinomas, adenoma-related lesions were detected in 7 and 1 case, respectively. All eight carcinomas arising in the adenoma were well-differentiated solitary tumors. The diameters of the carcinomas in the adenoma were, on average, larger than that of the benign adenomas (1.8 cm vs. 0.9 cm, p=0.01). The patients with carcinomas in the adenoma were, on average, older than those with benign adenomas, although the difference was insignificant (57 years vs. 47 years, p=0.09). The morphology and consisting epithelium did not differ between the benign adenomas and carcinomas in the adenoma. The malignant transformation occurred in 23.5% of adenomas.
Gallbladder adenoma is a rare disease, although malignant transformation occurs frequently. Adenoma is a precancerous lesion and the adenoma-carcinoma sequence is one of the gallbladder cancer carcinogenesis.
背景/目的：为了确定胆囊腺瘤进展为癌的恶性潜能，我们评估了胆囊切除标本中腺瘤及腺瘤相关病变的组织病理学特征。
在1847例胆囊切除标本中，选取了来自26例良性腺瘤、9例原位癌（CIS）和28例浸润性癌的63份标本。一名病理学家检查了所有标本，选取了良性腺瘤、腺瘤内的原位癌以及浸润性癌中的腺瘤残留。腺瘤及腺瘤相关病变根据形态（管状、管乳头状和乳头状）和组成上皮（胆管、幽门化生和肠化生）进行分类。还比较了良性腺瘤及腺瘤内癌的年龄和大小。
在所有切除的胆囊中，有34例（1.8%）发现了腺瘤及腺瘤相关病变。在9例原位癌和28例浸润性癌中，分别有7例和1例检测到腺瘤相关病变。腺瘤内发生的所有8例癌均为高分化孤立性肿瘤。腺瘤内癌的直径平均大于良性腺瘤（1.8 cm对0.9 cm，p = 0.01）。腺瘤内有癌的患者平均年龄大于良性腺瘤患者，尽管差异不显著（57岁对47岁，p = 0.09）。良性腺瘤与腺瘤内癌在形态和组成上皮方面无差异。23.5%的腺瘤发生了恶变。
胆囊腺瘤是一种罕见疾病，尽管恶变频繁发生。腺瘤是一种癌前病变，腺瘤-癌序列是胆囊癌发生机制之一。
