Ben Slama Sana, Ennaifer Rym, Bacha Dhouha, Bayar Rached, Bouraoui Saadia, Gharbi Lassaad, Lahmar Ahlem
Tunis Med. 2016 Jun;94(6):167-171.
Background - The gallbladder cancer is a rare cancer with poor prognosis. The association with gallstone disease is the main risk factor of this cancer. Aim - Describe the demographics, clinic-pathologic and therapeutic management of incidentally gallbladder cancer diagnosed on cholecystectomy specimens. Methods - retrospective study including 30 cases of gallbladder cancer incidentally detected on cholecystectomy specimens. Results - The incidence of gallbladder cancer incidentally discovered was 0.83%. The sex ratio M/F was 0.5 and the average age was 68 years. The main risk factor was cholelithiasis (38%). Adenocarcinoma was the most frequent histological type found in 86.6% of cases and it was biliary-type in 56.6% of cases. 76,7% of the tumors were classified in early stages (stages 0, I and II) and 23,3% were in advanced stages (III and IV). A simple cholecystectomy was curative in 66.7% of cases. Overall survival rate was 56.7% at one year. The best survival rate was for the early stages: 100% stages 0-I and 45.4% stage II. Conclusions - The gallbladder cancer has poor prognosis because of its late diagnosis. Thorough sampling and careful attention on histological examination of all parts of cholecystectomy specimens allows detection of early cancer with better prognosis.
背景 - 胆囊癌是一种预后较差的罕见癌症。与胆囊结石疾病的关联是这种癌症的主要危险因素。目的 - 描述在胆囊切除标本中偶然诊断出的胆囊癌的人口统计学、临床病理及治疗管理情况。方法 - 回顾性研究，纳入30例在胆囊切除标本中偶然发现的胆囊癌病例。结果 - 偶然发现的胆囊癌发病率为0.83%。男女比例为0.5，平均年龄为68岁。主要危险因素是胆石症（38%）。腺癌是最常见的组织学类型，在86.6%的病例中出现，其中56.6%为胆管型。76.7%的肿瘤被归类为早期阶段（0、I和II期），23.3%为晚期阶段（III和IV期）。单纯胆囊切除术在66.7%的病例中具有治愈性。一年总体生存率为56.7%。早期阶段的生存率最佳：0 - I期为100%，II期为45.4%。结论 - 胆囊癌因其诊断较晚而预后较差。对胆囊切除标本的所有部位进行全面取材并在组织学检查时仔细关注，有助于检测出预后较好的早期癌症。
