Di Mauro Davide, Orabi Amira, Myintmo Aye, Reece-Smith Alex, Wajed Shahjehan, Manzelli Antonio
Department of Upper GI Surgery, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX25DW, UK.
Discov Oncol. 2021 Feb 15;12(1):4. doi: 10.1007/s12672-021-00399-5.
Gallbladder carcinoma is often found incidentally on histopathologic examination after cholecystectomy-this is referred as incidental gallbladder carcinoma (IGC). Routine vs selective histopathological assessment of gallbladders is under debate and this study evaluates the role of regular specimens' examination, based on a single-centre analysis of incidence, clinical and histopathological aspects of IGC.
Patients who underwent cholecystectomy, between July 2010 and January 2020, were considered. Exclusion criteria were age under 18 and preoperative diagnosis of GB carcinoma. Demographic, clinical and histopathological data were retrospectively collected, continuous variables with a normal distribution were evaluated with Student's t-test and ANOVA.
Some 5779 patients were included. The female/male ratio was 2.5:1. Chronic cholecystitis (CC) was the most common finding on specimens (99.3%), IGC was found in six cases (0.1%). In the latter group, there were 5 women and patients were older than those with benign disease-73.7 [Formula: see text] 5.38 years vs 55.8 [Formula: see text] 0.79 years (p < 0.05). In all the cases, the GB was abnormal on intraoperative inspection and beside cancer, histopathology showed associated CC and/or dysplasia. Upon diagnosis, disease was at advanced stage-one stage II, one stage IIIA, one stage IIIB, three stage IVA. Two patients are alive, three died of disease progression-median survival was 7 months (range 2-14).
In this series, ICG was rare, occurred most commonly in old adult women and was diagnosed at an advanced stage. In all the cases, the GB was abnormal intraoperatively, therefore macroscopic GB anomalies demand histopathological assessment of the specimen.
胆囊癌常在胆囊切除术后的组织病理学检查中偶然发现，这被称为意外胆囊癌（IGC）。胆囊的常规组织病理学评估与选择性组织病理学评估存在争议，本研究基于对IGC的发病率、临床和组织病理学方面的单中心分析，评估常规标本检查的作用。
纳入2010年7月至2020年1月期间接受胆囊切除术的患者。排除标准为年龄小于18岁和术前诊断为胆囊癌。回顾性收集人口统计学、临床和组织病理学数据，对呈正态分布的连续变量采用Student's t检验和方差分析进行评估。
共纳入5779例患者。女性/男性比例为2.5:1。慢性胆囊炎（CC）是标本中最常见的发现（99.3%），6例发现IGC（0.1%）。在后一组中，有5名女性，患者年龄大于患有良性疾病的患者——73.7 [公式：见正文] 5.38岁对55.8 [公式：见正文] 0.79岁（p < 0.05）。在所有病例中，术中检查发现胆囊异常，除癌症外，组织病理学显示伴有CC和/或发育异常。诊断时，疾病处于晚期——1例II期，1例IIIA期，1例IIIB期，3例IVA期。2例患者存活，3例死于疾病进展——中位生存期为7个月（范围2 - 14个月）。
在本系列研究中，IGC罕见，最常见于老年成年女性，且诊断时处于晚期。在所有病例中，术中胆囊均异常，因此胆囊的宏观异常需要对标本进行组织病理学评估。
