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[胆固醇沉着症与胆囊癌之间的关联]

[Association between cholesterolosis and gallbladder cancer].

作者信息

Roa Iván, de Aretxabala Xabier, Ibacache Gilda, Muñoz Sergio

机构信息

Servicio de Anatomia Patológica, Clínica Alemana de Santiago, Facultad de Medicina Universidad del Desarrollo.

出版信息

Rev Med Chil. 2010 Jul;138(7):804-8.

Abstract

BACKGROUND

Cholesterolosis is frequently observed in cholecystectomies performed for lithiasis or chronic cholecystitis.

AIM

To determine the degree of association between cholesterolosis and gallbladder cancer.

MATERIAL AND METHODS

In a prospective study of gallbladder cancer, all gallbladders obtained during cholecystectomies were processed for pathological study, following a special protocol. As part of this study, 23,304 surgical samples obtained between 1993 and 2002 were studied, looking for a relationship between cholesterolosis and chronic cholecystitis, adenomas, dysplasia and gallbladder cancer.

RESULTS

Seventy nine percent of patients were women. Cholesterolosis was observed in 3123 cases (13.4%). Cholesterolosis was more common in women (14.2%) than in men (10.2%9) (p < 0.001). In the same period, 29 patients were diagnosed with adenomas (0.12%), 179 cases with dysplasia not associated with gallbladder cancer (0.8%) and 739 gallbladder cancer (3.2%). The frequency of cholesterolosis was 13.8% in chronic cholecystitis, 13.7% in adenomas, 12.1% in dysplasias and 1.35% in patients with gallbladder cancer (p < 0.01). Of the thirteen cases with gallbladder cancer and cholesterolosis, 10 were early gallbladder carcinomas. Patients with cholesterolosis were 9.2 times less likely td have cancer than those who did not have cholesterolosis.

CONCLUSIONS

Cholesterolosis has a strong negative association with gallbladder cancer.

摘要

背景

在因结石或慢性胆囊炎而进行的胆囊切除术中,经常观察到胆固醇沉着症。

目的

确定胆固醇沉着症与胆囊癌之间的关联程度。

材料与方法

在一项关于胆囊癌的前瞻性研究中,按照特殊方案对胆囊切除术中获取的所有胆囊进行病理研究。作为本研究的一部分,对1993年至2002年间获取的23304份手术样本进行研究,以寻找胆固醇沉着症与慢性胆囊炎、腺瘤、发育异常和胆囊癌之间的关系。

结果

79%的患者为女性。3123例(13.4%)观察到胆固醇沉着症。胆固醇沉着症在女性中(14.2%)比在男性中(10.2%)更常见(p<0.001)。同期,29例患者被诊断为腺瘤(0.12%),179例为与胆囊癌无关的发育异常(0.8%),739例为胆囊癌(3.2%)。胆固醇沉着症的发生率在慢性胆囊炎中为13.8%,在腺瘤中为13.7%,在发育异常中为12.1%,在胆囊癌患者中为1.35%(p<0.01)。在13例患有胆囊癌和胆固醇沉着症的病例中,10例为早期胆囊癌。患有胆固醇沉着症的患者患癌的可能性比没有胆固醇沉着症的患者低9.2倍。

结论

胆固醇沉着症与胆囊癌有很强的负相关。

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