胆囊癌综合治疗回顾性分析.docVIP

胆囊癌综合治疗回顾性分析 　　作者：田志杰，杨勇，张勇，李济宇，岳嘉宁，全志伟 作者单位：(上海交通大学医学院附属新华医院 200092) 　　【摘要】 目的 探讨提高胆囊癌的临床综合诊治方法。方法 回顾性分析我院2000年8月-2005年5月收治的胆囊癌住院患者的病史资料，并进行相关统计分析。结果 本组43例患者，男∶女为1∶2.3，中位年龄69岁。30例(69.8%)合并胆囊结石或胆管结石。30例(69.8%)CA19-9指标升高，13例(30.2%)CEA升高。35例(81.4%)术前由CT或MRI提示胆囊恶性肿瘤可能。43例患者中共30例(69.8%)行手术治疗，其中9例行根治术或扩大根治术。共14例患者接受化学治疗。本组资料共随访30例患者，5例患者仍然存活，最长存活已超过4年，其余患者生存期1~24个月，中位生存期为15个月。结论 胆囊癌的恶性程度高，预后差，术前诊断困难，缺乏敏感性和特异性均高的诊断方法，手术是治疗的主要手段。以化疗为主的胆囊癌新辅助治疗可能有助于进一步提高胆囊癌生存率，改善预后。 　　【关键词】 胆囊肿瘤;外科手术;治疗;化学疗法，辅助;放射疗法;药物疗法 　　Retrospective analysis on gallbladder cancer in 43 cases TIAN Zhijie， YANG Yong， ZHANG Yong， et al. Department of Surgery， Xinhua Hospital， Shanghai Jiaotong University， School of Medicine， Shanghai 200092 　　Abstract Objective To explore the clinical comprehensive diagnostic and treating method for gallbladder cancer. Methods A retrospective analysis on the clinical data was made for the patients of gallbladder cancer from April 2000 to May 2005 in our hospital. Results Forty-three cases was survey and the ratio of male vs female was 1∶2.3. Cholecystic cancer complicated with cholecystic stone and biliary tract stone was 69.8% and CA19-9 was elevated in 69.8% patients and CEA in 30.2% patients. 81.4% patients was diagnosed as cancer by CT or MRI. Thirty cases underwent operation and 9 cases of whom underwent radical resection or aggressive approach. Chemotherapy was applied in 14 patients. Thirty cases were followed up. Five cases were alive now and 1 cases lived longer than 4 years. The survival time for the other cases was from 1 to 24 months. The median was 15 months. Conclusion Gallbladder cancer is difficult to be diagnosed and lack of good diagnostic methods. Operation is still the major therapy and chemotherapy may be helpful for gallbladder cancer. 　　Key words gallbladder neoplasms; surgery; treatment; chemotherapy， adjuvant; radiotherapy; drug therapy 　　胆囊癌是胆道系统最常见的恶性肿瘤，其发病率逐年上升，恶性程度高，预后差。现对我院的胆囊癌患者的病史资料进行回顾性分析，以期对提高胆囊癌的临床诊治水平提供借鉴。