Kim Ji Hun, Jeong In Ho, Han Jae Ho, Kim Jang Hee, Hwang Jae Chul, Yoo Byung Moo, Kim Jin Hong, Kim Myung Wook, Kim Wook Hwan
Department of Surgery, School of Medicine, Ajou University, Suwon, Korea.
Hepatogastroenterology. 2010 May-Jun;57(99-100):420-5.
BACKGROUND/AIMS: The aim of this study was to analyze the clinical/pathological outcomes of patients that underwent surgery for gallbladder adenomyomatosis, to clarify the characteristics of the type and pathogenesis of adenomyomatosis.
From May 1997 to March 2008, 4704 consecutive patients underwent cholecystectomy at Ajou University Medical Center. Among them, 113 (2.4%) patients that were histopathologically diagnosed with adenomyomatosis or adenomatous hyperplasia were selected for this study. The patients were divided into a fundal type group and a segmental/diffuse type group, and the specimens reviewed with Hematoxylin-Eosin (H & E) and immunohistochemical stainings.
Sixty-three patients were male and 50 female; the age ranged from 17 to 76 years of age. The fundal type was the most common type. Gallstones were present in 69.9% of the patients. In the analysis of the fundal and segmental/diffuse types, gallstones were present in 23 patients with fundal type and in 53 patients with segmental/diffuse type; this difference was statistically significant (p < 0.05). Review of H & E staining showed that the most common findings were grade 1 (n = 14) in the fundal type and grade 2 (n = 23) in the segmental/diffuse type; there was a significant difference in the inflammatory grade (p < 0.05). Immunohistochemical staining showed expression of vimentin, as a mesenchymal marker in 28.0% of cases (n = 16).
The fundal type differed from the segmental/diffuse type based on the clinical/ pathological features; it had a lower frequency of gallstones and a lower inflammatory grade. In addition, no cancer was identified in the resected gallbladders of patients with adenomyomatosis. The findings suggest that the Rokitansky-Aschoff sinuses (RAS) were associated with acquired motility, based on the expression of vimentin, consistent with an epithelial-mesenchymal transition.
背景/目的：本研究旨在分析接受胆囊腺肌症手术患者的临床/病理结局，以阐明腺肌症的类型特点及发病机制。
1997年5月至2008年3月，4704例患者在阿朱大学医学中心连续接受胆囊切除术。其中，113例（2.4%）经组织病理学诊断为腺肌症或腺瘤样增生的患者被纳入本研究。患者被分为基底型组和节段性/弥漫型组，并对标本进行苏木精-伊红（H&E）染色及免疫组织化学染色检查。
63例为男性，50例为女性；年龄范围为17至76岁。基底型是最常见的类型。69.9%的患者存在胆结石。在基底型和节段性/弥漫型的分析中，23例基底型患者和53例节段性/弥漫型患者存在胆结石；这种差异具有统计学意义（p < 0.05）。H&E染色检查显示，最常见的结果在基底型中为1级（n = 14），在节段性/弥漫型中为2级（n = 23）；炎症分级存在显著差异（p < 0.05）。免疫组织化学染色显示，波形蛋白作为间充质标志物在28.0%的病例（n = 16）中表达。
基于临床/病理特征，基底型与节段性/弥漫型不同；其胆结石发生率较低，炎症分级也较低。此外，在腺肌症患者切除的胆囊中未发现癌症。这些发现表明，基于波形蛋白的表达，罗-阿窦（RAS）与获得性运动性相关，这与上皮-间充质转化一致。
