Clinicopathological features of gallbladder papillary adenocarcinoma.
Clinicopathological features of gallbladder papillary adenocarcinoma.
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胆囊乳头状腺癌的临床病理特征
DOI：
10.1097/md.0000000000000131
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发表时间：
2014-12
期刊：
影响因子：
1.6
通讯作者：
Sang X
中科院分区：
文献类型：
--
作者：
Wan X;Zhang H;Chen C;Yang X;Wang A;Zhu C;Fu L;Miao R;He L;Yang H;Zhao H;Sang X
虽然胆囊乳头状腺癌（GBPA）患者的预后似乎优于其他病理亚型的胆囊癌（GBC）患者，但GBPA的临床病理特征和预后尚未得到充分探讨。因此，本研究分析了GBPA的临床病理特征和结果。本研究包括16例GBPA和101例胆囊腺癌（GBA），未另行说明（NOS），所有患者均经手术切除后病理诊断。回顾性收集并比较两组患者的临床病理和生存资料，发热在GBPA中明显更常见（7/16 vs 10/101; P = 0.000）。 GBPA组9例中1例血清糖链抗原19-9升高，GBA组76例中39例血清糖链抗原19-9升高（P = 0.022）。 更多的GBPA患者接受了根治性切除术（15/16 vs 54/101; P = 0.009）。 病理学上，GBPA患者的肿瘤（T）（原位4例，T1 8例; P = 0.000）和肿瘤、淋巴结、转移（TNM）分期（P = 0.000）更早。 GBPA患者的1年、3年和5年总生存率（分别为100%、76.9%和76.9%）显著高于GBA患者（分别为72.2%、38.8%和31.0%; P = 0.001）。 术前黄疸（OR 7.69，95%CI 1.53-38.76，P = 0.013）是GBA患者的一个重要预后因素，但合并GBA和GBPA患者时，其预后不再显著。 合并患者可能会掩盖各组的预后因素。
AbstractAlthough patients with gallbladder papillary adenocarcinoma (GBPA) appear to have better prognoses than patients with other pathological subtypes of gallbladder carcinoma (GBC), the clinicopathological features and outcomes of GBPA have not been fully explored. This study therefore analyzed the clinicopathological characteristics and outcomes of GBPA.This study included 16 patients with GBPA and 101 with gallbladder adenocarcinoma (GBA) not otherwise specified (NOS), all diagnosed pathologically after surgical resection. Clinicopathological and survival data were retrospectively collected and compared.Fever was significantly more common in GBPA (7/16 vs 10/101; P = 0.000). Serum carbohydrate antigen 19-9 level was increased in 1 of 9 patients with GBPA and 39 of 76 with GBA (P = 0.022). More patients with GBPA underwent curative resection (15/16 vs 54/101; P = 0.009). Pathologically, patients with GBPA were at much earlier tumor (T) (4 in situ, 8 T1; P = 0.000) and Tumor, Node, Metastases (TNM) stages (P = 0.000). The overall 1-, 3-, and 5-year survival rates were significantly higher in patients with GBPA (100%, 76.9%, and 76.9%, respectively), than in patients with GBA (72.2%, 38.8%, and 31.0%, respectively; P = 0.001). Preoperative jaundice (odds ratio 7.69; 95% confidence interval, 1.53–38.76; P = 0.013) was a significant prognostic factor in patients with GBA, but was no longer significant when the patients with GBA and GBPA were pooled together.The clinicopathological features of patients with GBPA differed from those in patients with GBA (not otherwise specified). Pooling of patients may mask prognostic factors in each group.