Koga A, Watanabe K, Fukuyama T, Takiguchi S, Nakayama F
Department of Surgery I, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Arch Surg. 1988 Jan;123(1):26-9. doi: 10.1001/archsurg.1988.01400250028003.
In 411 patients undergoing cholecystectomy, benign polyps were present in 32 gallbladders and malignant polyps were present in eight. Histologically, cholesterol polyps accounted for most of the benign lesions, and all the malignant lesions were adenocarcinomas. Gallstones coexisted in 50% of the malignant lesions and endoscopic retrograde cholangiography revealed anomalous pancreaticobiliary junctions in three of five patients with malignant lesions. Sixty-nine percent of patients with benign lesions were under 60 years of age, whereas 75% of those with malignant lesions were over 60. Ninety-four percent of the benign lesions were under 1.0 cm in diameter, while 88% of the malignant lesions exceeded this size. Spread and size of the tumor showed a close correlation. Therefore, size of the tumor is a vital indicator in the treatment of polypoid lesions of the gallbladder, and a malignancy should be considered when the tumor exceeds 1.0 cm in diameter.
在411例行胆囊切除术的患者中，32个胆囊存在良性息肉，8个存在恶性息肉。组织学上，胆固醇息肉占大多数良性病变，所有恶性病变均为腺癌。50%的恶性病变合并胆囊结石，内镜逆行胆管造影显示5例恶性病变患者中有3例存在胰胆管异常汇合。69%的良性病变患者年龄在60岁以下，而75%的恶性病变患者年龄超过60岁。94%的良性病变直径小于1.0 cm，而88%的恶性病变超过此大小。肿瘤的扩散和大小显示出密切相关性。因此，肿瘤大小是胆囊息肉样病变治疗中的一个重要指标，当肿瘤直径超过1.0 cm时应考虑恶性可能。
