Department of Histopathology, Berkshire Surrey Pathology Services, Royal Surrey County Hospital, Guildford, UK.
Pathologica. 2022 Apr;114(2):138-145. doi: 10.32074/1591-951X-291.
To identify and compare significant or relevant prognostic factors in pre-operatively diagnosed, surgically resectable, gallbladder cancer and in incidentally detected gallbladder cancer cases.
Gallbladder resections (October 2009-March 2016) were identified on the histopathology Winpath database. Cases with a final histological diagnosis of gallbladder cancer (GBC) were categorised into: Group A: clinically suspected operable GBC (n = 13). Group B: incidental GBC with staged liver bed resection (n = 5). Group C: incidental GBC without staged liver bed resection (n = 15). The clinicopathological features were analysed in each group separately.
The overall incidence of primary (GBC) was 0.66% and all the cases were adenocarcinomas, of which, 6 of 33 (18.2%) were grade 1 and 15 of 33 (45.4%) were grade 3. Male to female ratio is 1:2.3. Of the 33 patients with GBC 14 (42.4%) has died of disease at 18-month follow-up. 15 of 33 had perineural invasion and 10/21 (47.6%) cases showed lymph node matastasis. Six cases had positive surgical margin and 9/15 showed direct liver invasion. Higher stage disease (T3/T4) was seen in 10/14 cases.
The prognosis of primary GBC is poor and best clinical outcomes can be achieved with early diagnosis followed by radical cholecystectomy and staged liver resection with negative margins.
确定并比较术前诊断、可手术切除的胆囊癌和偶然发现的胆囊癌病例中的显著或相关预后因素。
在组织病理学 Winpath 数据库中确定胆囊切除术（2009 年 10 月至 2016 年 3 月）。具有最终组织学诊断为胆囊癌（GBC）的病例分为以下三组：A 组：临床怀疑可手术 GBC（n=13）；B 组：有分期肝床切除术的偶然 GBC（n=5）；C 组：无分期肝床切除术的偶然 GBC（n=15）。分别对每组的临床病理特征进行分析。
原发性（GBC）的总发生率为 0.66%，所有病例均为腺癌，其中 6/33（18.2%）为 1 级，15/33（45.4%）为 3 级。男女比例为 1:2.3。在 33 例 GBC 患者中，14 例（42.4%）在 18 个月随访时因疾病死亡。15/33 例有神经周围侵犯，10/21（47.6%）例有淋巴结转移。6 例有阳性手术切缘，9/15 例有直接肝侵犯。10/14 例为较高分期疾病（T3/T4）。
原发性 GBC 的预后较差，早期诊断后行根治性胆囊切除术和分期肝切除术并获得阴性切缘可获得最佳临床结果。
