Dowling G P, Kelly J K
Cancer. 1986 Oct 15;58(8):1702-8. doi: 10.1002/1097-0142(19861015)58:8<1702::aid-cncr2820580821>3.0.co;2-z.
A prospective study of 277 cholecystectomy specimens for evidence of isolated epithelial dysplasia of gallbladder mucosa is presented. In addition, 15 cases of primary adenocarcinoma of the gallbladder are retrospectively reviewed with particular reference to the presence of metaplasia and dysplasia adjacent to the infiltrating tumor, in order to establish the relationship between metaplasia, isolated epithelial dysplasia, and adenocarcinoma of the gallbladder. Only one case of isolated epithelial dysplasia was found in the 277 cholecystectomy specimens, and this arose within focal incomplete intestinal metaplasia. In the 15 cases of adenocarcinoma of the gallbladder, benign antral and/or incomplete intestinal metaplasia was found adjacent to the tumor in 11 cases. In 10 cases, dysplasia of this metaplastic epithelium was found in continuity with the tumor. The authors conclude that the most common pathway to adenocarcinoma is via dysplasia of metaplastic gallbladder epithelium.
本文呈现了一项对277例胆囊切除术标本进行的前瞻性研究，以寻找胆囊黏膜孤立性上皮发育异常的证据。此外，回顾性分析了15例原发性胆囊腺癌病例，特别关注浸润性肿瘤旁化生和发育异常的存在情况，以确立化生、孤立性上皮发育异常与胆囊腺癌之间的关系。在277例胆囊切除术标本中仅发现1例孤立性上皮发育异常，且该病例出现在局灶性不完全肠化生中。在15例胆囊腺癌病例中，11例在肿瘤旁发现良性胃窦和/或不完全肠化生。10例中，这种化生上皮的发育异常与肿瘤相连。作者得出结论，腺癌最常见的发展途径是通过化生的胆囊上皮发育异常。
