Yamagiwa H, Tomiyama H, Onishi T
Department of Clinical Pathology, Mie Univ. School of Med.
Gan No Rinsho. 1989 Jan;35(1):41-5.
Out of 2,027 resected gallbladders that were examined, 46 (2.2%) manifested dysplasia and, to study this further, step sections, 5 mm apart, were performed. The average age of these dysplastic cases was 63.8 years, with a male to female ratio of 1:3. The most frequent dysplastic sites in the gallbladder were in the fundus and the body. Excluding adenomas, polypoid lesions, the dysplasia appeared flat, granular, or irregular. As to diameter, 68.6% were within 1 cm, and 89% were no more than 2 cm. The majority of cases manifesting mild dysplasia had lesions of up to 5 mm in size while the lesions seen in moderate cases were within 2 cm. Stones were found in 80.4% of the cases, and incidences of intestinal metaplasia and pseudopyloric gland metaplasia were found in 80.4% and 100% of these cases, respectively. Incidences of dysplasia adjacent to the carcinoma was seen in 41.8% of the cases, and frequently found in early-stage lesions and well-differentiated carcinomas. Our findings have led us to believe that recognition of the intestinal metaplasia-dysplasia-carcinoma sequence is important.
在接受检查的2027个切除胆囊中，46个（2.2%）表现出发育异常，为进一步研究，进行了间隔5毫米的连续切片。这些发育异常病例的平均年龄为63.8岁，男女比例为1:3。胆囊中最常见的发育异常部位是底部和体部。排除腺瘤、息肉样病变后，发育异常表现为扁平、颗粒状或不规则状。就直径而言，68.6%在1厘米以内，89%不超过2厘米。大多数表现为轻度发育异常的病例病变大小在5毫米以内，而中度病例的病变在2厘米以内。80.4%的病例发现有结石，这些病例中肠化生和假幽门腺化生的发生率分别为80.4%和100%。41.8%的病例在癌旁发现发育异常，且在早期病变和高分化癌中经常发现。我们的研究结果使我们相信，认识肠化生-发育异常-癌序列很重要。
