Department of Surgery, Ehime University Hospital, Toon, Japan.
Scand J Surg. 2020 Dec;109(4):301-308. doi: 10.1177/1457496919866016. Epub 2019 Jul 29.
T2 gallbladder cancer requires lymph node dissection for curative resection, whereas simple cholecystectomy is adequate to treat T1 gallbladder cancer. Hence, this study aimed to develop an accurate scoring system to preoperatively predict pT2 in gallbladder cancer.
We retrospectively assessed data from 57 patients with suspected gallbladder cancer who underwent curative resection between September 2003 and May 2017. Six with apparent invasion of adjacent organs on preoperative images were excluded. We evaluated preoperative computed tomography, magnetic resonance and endoscopic ultrasonographic images, blood biochemistry, and the maximum standard uptake value in fluorodeoxyglucose-positron emission tomography images. We analyzed whether correlations between preoperative findings and the depth of tumor invasion could predict pT2.
The pathological diagnosis was gallbladder cancer in 30 (58.8%) patients, of whom 21 (69.9%) had pT2 or worse. Multivariate analyses selected carcinoembryonic antigen and tumor diameter as independent predictors of pT2 or worse (odds ratios = 1.741 and 1.098, respectively; 95% confidence intervals = 1.004-3.020 and 1.008-1.197, respectively). A regression formula was created using carcinoembryonic antigen and tumor diameter to calculate pT2 predictive scores. The area under the receiver operating characteristics curve of the pT2 predictive score was 0.873.
We created a scoring system to predict pT2 in gallbladder cancer using carcinoembryonic antigen and tumor diameter. The present findings suggested that carcinoembryonic antigen is important for the preoperative evaluation of gallbladder cancer.
T2 期胆囊癌需要行淋巴结清扫才能达到根治性切除，而 T1 期胆囊癌只需单纯行胆囊切除术即可。因此，本研究旨在建立一种准确的评分系统，用于术前预测胆囊癌的 pT2 期。
我们回顾性评估了 2003 年 9 月至 2017 年 5 月期间 57 例接受根治性切除术的疑似胆囊癌患者的数据。术前影像学检查显示 6 例患者有邻近器官明显侵犯，排除这 6 例患者。我们评估了术前计算机断层扫描、磁共振成像和内镜超声检查图像、血液生化以及氟脱氧葡萄糖正电子发射断层扫描图像中的最大标准摄取值。我们分析了术前发现与肿瘤侵袭深度之间的相关性是否可以预测 pT2 期。
病理诊断为胆囊癌的患者有 30 例（58.8%），其中 21 例（69.9%）为 pT2 期或更差。多因素分析选择癌胚抗原和肿瘤直径作为预测 pT2 期或更差的独立预测因子（比值比分别为 1.741 和 1.098；95%置信区间分别为 1.004-3.020 和 1.008-1.197）。使用癌胚抗原和肿瘤直径建立了一个回归公式，用于计算 pT2 预测评分。pT2 预测评分的受试者工作特征曲线下面积为 0.873。
我们使用癌胚抗原和肿瘤直径建立了一个预测胆囊癌 pT2 期的评分系统。本研究结果表明，癌胚抗原对胆囊癌的术前评估很重要。
