Sharma Sanjeev, Walia Bhupinder Singh, Randhawa Mandeep, Sharma Arjun, Dugg Pankaj, Pannu Jiteshwar Singh
Department of Surgery, Government Medical College, Amritsar, India.
Department of Pathology, Government Medical College, Amritsar, India.
Ann Hepatobiliary Pancreat Surg. 2023 Aug 31;27(3):277-286. doi: 10.14701/ahbps.23-010. Epub 2023 Aug 7.
BACKGROUNDS/AIMS: To study histopathological changes in gall bladder mucosa in cholelithiasis patients, and analyse their relation to the number and size of gallstones. These findings were evaluated in the context of age distribution of the study population.
One hundred cases of cholecystectomy were part of the study, which was conducted in collaboration with the pathology department. The time period of the study was January 2020 to June 2021.
Maximum cases had multiple stones (69.0%), while one third cases (31.0%) had solitary stones. While initial univariate analysis showed age (odds ratio [OR], 6.882; = 0.043), gallstone number (OR, 9.1; = 0.050), gallstone size (OR, 17.111; = 0.013), and duration of symptom (OR, 34.125; = 0.001) to be significant risk factors associated with gallbladder carcinoma, multivariate analysis found none of these variables to be significant. However, conditional multivariate analysis for the duration of symptom ( = 0.008; OR, 21.118) yielded significant p- value. With histopathological diagnoses, 5% of cases had gallbladder cancer.
This study shed light on the rising incidence of cholelithiasis in the young population and the high rate of gallbladder carcinoma in Punjab, India. Although gall stone characteristics (size, number) and patient age appeared to be significant risk factors when their individual relation with gallbladder carcinoma was studied, multivariate analysis, could not prove that. Conditional multivariate analysis showed the duration of symptom to be the only significant risk factor associated with gallbladder carcinoma. Further research with larger sample size is needed to study the rising incidence of gallbladder carcinoma, and the risk factors associated with it.
背景/目的:研究胆石症患者胆囊黏膜的组织病理学变化,并分析其与胆结石数量和大小的关系。在研究人群年龄分布的背景下对这些发现进行评估。
100例胆囊切除术病例纳入本研究,该研究与病理科合作开展。研究时间段为2020年1月至2021年6月。
大多数病例有多个结石(69.0%),而三分之一的病例(31.0%)有单个结石。虽然初始单因素分析显示年龄(优势比[OR],6.882;P = 0.043)、胆结石数量(OR,9.1;P = 0.05)、胆结石大小(OR,17.111;P = 0.013)和症状持续时间(OR,34.125;P = 0.001)是与胆囊癌相关的显著危险因素,但多因素分析发现这些变量均无显著性。然而,对症状持续时间进行的条件多因素分析(P = 0.008;OR,21.118)得出了显著的P值。根据组织病理学诊断,5%的病例患有胆囊癌。
本研究揭示了印度旁遮普邦年轻人群中胆石症发病率的上升以及胆囊癌的高发病率。虽然在研究胆结石特征(大小、数量)与胆囊癌的个体关系时,患者年龄似乎是显著的危险因素,但多因素分析未能证实这一点。条件多因素分析显示症状持续时间是与胆囊癌相关的唯一显著危险因素。需要进行更大样本量的进一步研究,以研究胆囊癌发病率的上升情况及其相关危险因素。