Black W C, Key C R, Carmany T B, Herman D
Cancer. 1977 Mar;39(3):1267-79. doi: 10.1002/1097-0142(197703)39:3<1267::aid-cncr2820390338>3.0.co;2-0.
The clinical and pathological characteristics of gallbladder carcinoma were studied in a group of 56 Southwestern American Indian patients. This is the third most common malignant tumor among American Indian females in a population served by the New Mexico Tumor Registry accounting for 8.5% of specific cancer diagnoses by site. Carcinoma of the gallbladder is relatively more common within the Indian population than among Spanish Americans or Anglos living in this area. This is true for both sexes. No significant differences in average age at diagnosis, ratio of female to male patients, signs and symptoms, stage at diagnosis or survival were detected in comparison with studies pertaining to gallbladder carcinoma in non-Indian populations. A squamous cell carcinoma component was unusually common however, and carcinoma in situ or atypical adenomatous hyperplasia of the mucosa was frequently documented adjacent to invasive carcinoma. Although gall stones were present in tumor containing gallbladders in 93% of cases, elective cholecystectomy for cholelithiasis is probably not a practical means of prevention of this tumor in view of the unusual frequency of cholelithiasis in Indian women. Pharmacological conversion of bile to a non-lithogenic form may deserve consideration as prophylaxis against both cholelithiasis and carcinoma of the gallbladder in this population.
对一组56名美国西南部印第安患者的胆囊癌临床和病理特征进行了研究。在新墨西哥肿瘤登记处服务的人群中，这是美国印第安女性中第三常见的恶性肿瘤，占特定癌症部位诊断的8.5%。胆囊癌在印第安人群中比生活在该地区的西班牙裔美国人或盎格鲁人相对更常见。男女皆是如此。与非印第安人群中胆囊癌的研究相比，在诊断时的平均年龄、女性与男性患者比例、体征和症状、诊断阶段或生存率方面未发现显著差异。然而，鳞状细胞癌成分异常常见，并且在浸润性癌附近经常记录到原位癌或黏膜非典型腺瘤样增生。尽管93%的含肿瘤胆囊中有胆结石，但鉴于印第安女性胆结石的异常高发率，因胆石症进行择期胆囊切除术可能不是预防这种肿瘤的实际方法。在该人群中，将胆汁药理学转化为非致石形式可能值得考虑作为预防胆石症和胆囊癌的措施。
