Shukla Sanjeev Kumar, Pant Prabhat, Singh Govind, Shahi K S
Multidisciplinary Research Unit, Government Medical College, Haldwani, Nainital, Uttarakhand, 263139, India.
Department of Pathology, Government Medical College, Haldwani, Nainital, Uttarakhand, 263139, India.
J Gastrointest Cancer. 2020 Mar;51(1):121-129. doi: 10.1007/s12029-018-00188-4.
Gall stones are one of the major causes of morbidity and mortality all over the world and common health problems throughout in developing countries. Cholecystectomy is one of the most common surgical practices and postoperative analysis of cholecystectomy specimen has a great value since histopathological reports may document some entities with significant clinical significances. Gallbladder carcinomas in cholecystectomy specimens are received in our histopathology laboratory to analyse their clinicopathological features. This was a descriptive study carried out at the histopathology section of the Department of Pathology at our hospital over a period of two years ranging from November 2016 to October 2018. Both intraoperative and postoperative histological examinations of the excised gallbladder facilitated the diagnosis of gallbladder cancer. Surgery-related variables and surgical approaches were evaluated according to the extent of tumor invasion. Twenty five cholecystectomy specimens of the acute and symptomatic chronic cholecystitis patients were analyzed. Standardization of the reporting were examined. Age, gender, presence of gall stone, cholesterolosis, adenomatous hyperplasia, gastric or intestinal metaplasia, dysplasia, histopathological type of gallbladder carcinoma, cellular differentiation, grading, lympho vascular invision, perineural invasion, lymph node invasion, involvement of cystic duct end margin, liver invasion, omental tissue invasion and T.N.M. staging were investigated. Reported rates of histopathological findings were comparable between patients aged twenty six years to seventy six years. Epithelial hyperplasia and metaplasia were found to be related to age. The correlation between cholesterolosis and gender or metaplasia was noted. We suggest that in India and other nations, high incidences of gallbladder carcinoma, all cholecystectomy specimens must be submitted to routine macroscopic and histopathology examination in the laboratory, as this is the only capability through which malignancies can be detected at an early, potentially curable stage. This incidental finding has altered the management and outcome of this dreadful disease.
胆结石是全球发病和死亡的主要原因之一,也是发展中国家普遍存在的健康问题。胆囊切除术是最常见的外科手术之一,对胆囊切除标本进行术后分析具有重要价值,因为组织病理学报告可能记录一些具有重要临床意义的实体。我们的组织病理学实验室接收胆囊切除标本中的胆囊癌,以分析其临床病理特征。这是一项描述性研究,于2016年11月至2018年10月在我院病理科的组织病理学部门进行了两年。对切除胆囊的术中及术后组织学检查有助于胆囊癌的诊断。根据肿瘤侵犯程度评估手术相关变量和手术方法。分析了25例急性和有症状慢性胆囊炎患者的胆囊切除标本。检查了报告的标准化情况。调查了年龄、性别、胆结石的存在、胆固醇沉着症、腺瘤样增生、胃或肠化生、发育异常、胆囊癌的组织病理学类型、细胞分化、分级、淋巴管侵犯、神经周围侵犯、淋巴结侵犯、胆囊管切缘受累、肝脏侵犯、网膜组织侵犯和TNM分期。26岁至76岁患者的组织病理学发现报告率具有可比性。发现上皮增生和化生与年龄有关。注意到胆固醇沉着症与性别或化生之间的相关性。我们建议,在印度和其他国家,由于胆囊癌发病率高,所有胆囊切除标本都必须提交实验室进行常规大体和组织病理学检查,因为这是在早期可治愈阶段检测恶性肿瘤的唯一方法。这一偶然发现改变了这种可怕疾病的治疗和预后。