临床外科杂志 ›› 2020, Vol. 28 ›› Issue (8): 744-746.doi: 10.3969/j.issn.1005-6483.2020.08.015

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胆囊肉瘤样癌五例临床分析

  

  1. 241000 安徽芜湖,皖南医学院弋矶山医院胃肠外科
  • 出版日期:2020-08-20 发布日期:2020-08-20

Sarcomatoidcarcinoma ofthe gallbladder:A report of 5 cases

  1. Department of Gastrointestinal Surgery,Yijishan Hospital of Wanan Medical College,Anhui Province,Wuhu241000,China
  • Online:2020-08-20 Published:2020-08-20

摘要: 目的  总结胆囊肉瘤样癌的临床特点、诊断、治疗及预后特点。
方法  2012年4月~2020年4月我院诊断为胆囊肉瘤样癌病人5例,分析病人症状体征、术前影像学、肿瘤标志物、手术及预后等情况。
结果  5例胆囊肉瘤样癌病人症状均无特异性。术前肿瘤标记物检查:CA-199升高2例,CA-125升高2例,CEA呈轻度升高1例,5例病人铁蛋白均明显升高,其影像学表现与胆囊腺癌无明显差异。4例行RO切除,1例R1切除,截止至末次随访时间,除最近1例病人术后8个月仍存活外,其余均未能获得长期生存。
结论  胆囊肉瘤样癌无特殊临床表现,其确诊依赖于病理及免疫组织化学检验,该类型肿瘤恶性程度高,进展迅速。临床治疗仍以手术根治性切除为主,其发生率极低,仍需大宗病例及长期随访以寻求更佳治疗方式。

关键词: 胆囊肉瘤样癌, 治疗, 预后

Abstract: Objective To explore the clinical characteristics,diagnosis,treatment and prognosis of sarcomatoid carcinoma of the gallbladder.
Methods Symptoms,syndrome,preoperative imaging,tumor markers,surgery and prognosis of five patients confirmed with sarcomatoid carcinoma of the gallbladder in our hospital from April 2012 to April 2020 were retrospectively analyzed.
Results The five patients had no obvious specificity.Preoperative tumor marker examination showed that CA-199 increased significantly in 2 patients.CA-125 increased significantly in 2 patients.CEA increased slightly in 1 patient,and ferritin increased significantly in 5 patients,there was no significant difference between the imaging findings and gallbladder adenocarcinoma.Four of them underwent R0 resection and one case underwent R1 resection.Up until the last follow-up visit,one patient survived at 8 months after surgery and the other four cases did not survive for a long term(survival time 63~340 day).
Conclusion Sarcomatoid carcinoma of the gallbladder has no specific clinical manifestations,so it isgenerally diagnosed via pathological examination and immunohistochemical examination.The cancer is highly malignant and progresses very rapidly.Radical excision is dominant in clinical treatment.Because its incidence rate is very low,more cases should be followed up for long term to search for better treatment.

Key words: gallbladdersarcomatoid carcinoma, treatment , prognosis

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