Kaul V, Wani N A, Paljor Y D
Indian J Pathol Microbiol. 1989 Jul;32(3):146-51.
The study presents the clinicopathological findings in thirty six cases of primary carcinoma of gall bladder diagnosed at SKIMS Srinagar over a period of four years (1983-86). Particular attention was paid to age, sex, presenting symptoms, presence of gall stones and site of metastasis. Majority of patients were found to be middle aged females (24 out of 36 cases). Most common presenting symptom was abdominal pain and duration of symptoms was two months or less in majority of cases. Gall stones were found in 55.5% cases. Diagnosis of primary gall bladder carcinoma was an incidental histopathological finding in 22% patients. Well differentiated adenocarcinoma was found to be the commonest type of malignancy (77.7%). 33% cases had widespread metastatic disease at the time of operation and liver was the commonest site of invasion (47.2%). Follow up records of 21 out of 36 patients available show only two patients to be alive till date with more than two year follow up and in both these cases carcinoma was an incidental histopathological diagnosis at cholecystectomy. Rest of the patients had died within 5-6 months after surgery. This reinforces the poor outcome for primary gall bladder carcinoma patients irrespective of treatment unless diagnosed and treated at a very early stage. Long term survival can be expected in incidentally found carcinoma at cholecystectomy.
该研究呈现了在斯利那加SKIMS医院四年期间（1983 - 1986年）诊断出的36例原发性胆囊癌的临床病理结果。特别关注了年龄、性别、呈现的症状、胆结石的存在情况以及转移部位。发现大多数患者为中年女性（36例中有24例）。最常见的呈现症状是腹痛，大多数病例中症状持续时间为两个月或更短。55.5%的病例发现有胆结石。22%的患者原发性胆囊癌的诊断是偶然的组织病理学发现。高分化腺癌是最常见的恶性肿瘤类型（77.7%）。33%的病例在手术时已有广泛转移疾病，肝脏是最常见的侵袭部位（47.2%）。36例患者中有21例的随访记录显示，仅有2例患者在超过两年的随访后至今仍存活，在这两例中，癌症均是在胆囊切除术中偶然的组织病理学诊断。其余患者在手术后5 - 6个月内死亡。这强化了原发性胆囊癌患者无论接受何种治疗，除非在极早期被诊断和治疗，否则预后都很差的情况。在胆囊切除术中偶然发现的癌症有望实现长期存活。
