胆道系统印戒细胞癌的临床病理特点及预后状况分析

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摘要目的分析胆道系统印戒细胞癌的临床病理特点及预后状况。方法回顾性分析11例于2007年5月～2016年10月在南京医科大学附属无锡市人民医院经病理确诊为胆道系统印戒细胞癌病例的临床病理资料，并随访其预后生存情况，随访截至2016年12月26日。结果 11例胆道系统印戒细胞癌患者中，男5例，女6例，男女比例为1∶1.2。患者发病年龄43～78岁，平均62.4岁。临床表现以右上腹不适[9例（81.8%）]、黄疸[7例（63.6%）]为主。发病部位为胆囊者7例（63.6%）。合并胆囊炎8例（72.7%）、胆结石7例（63.6%）。病理类型中腺癌伴印戒细胞癌较多[9例（81.8%）]，单纯印戒细胞癌较少[2例（18.2%）]。病理低分化6例（54.5%），伴远处转移8例（72.7%）。11例均行手术治疗，行化疗2例。截至随访结束日期，明确预后结局患者中死亡6例（75%），生存2例（25%）。总生存期为0～56个月，平均19.3个月。结论胆道系统印戒细胞癌临床罕见，常起病于中老年人群，胆囊部多发，临床表现以右上腹不适及黄疸为主，合并胆囊炎、胆结石可能为发病相关因素，病理类型以腺癌伴印戒细胞癌多见，恶性程度较高，患者确诊时多为肿瘤中晚期，手术为主要治疗方法，放化疗获益有待进一步研究，总体预后较差。

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	夏丹丹王润洁刘超英▲

关键词 ：胆道系统, 印戒细胞癌, 病理, 预后

Abstract：Objective To analyze the clinical pathological characteristics and prognosis of signet-ring cell carcinoma of biliary tract. Methods The clinical pathological data of 11 patients who were diagnosed as signet-ring cell carcinoma of biliary tract in Wuxi People's Hospital Affiliated to Nanjing Medical University from May 2007 to October 2016 was analyzed retrospectively, and the prognosis conditions of patients were followed up until December 26, 2016. Results Among 11 cases of patients with signet-ring cell carcinoma of biliary tract, there were 5 cases of male and 6 cases of female, the male to female ratio was 1∶1.2, the episode age was 43-78 years old, with an average of 62.4 years old, the main clinical symptoms were discomfort of right upper quadrant [9 cases (81.8%)] and jaundice [7 cases (63.6%)]. In the pathological location, there were 7 cases (63.6%) in gall bladder. There were 8 cases (72.7%) combined with cholecystitis, 7 cases (63.6%) combined with biliary calculus. In the pathological patterns, adenocarcinoma combined with signet-ring cell carcinoma was more [9 cases (81.8%)], single signet-ring cell carcinoma was less [2 cases (18.2%)]. There were 6 cases (54.5%) of low-differentiated and 8 cases (72.7%) with distant metastasis. All 11 cases took operative treatment, 2 cases received chemotherapy. At the end of the follow-up period, among the patients with definite prognosis, 6 cases (75%) were dead, 2 cases (25%) were survived. The overall survival time was 0-56 months, with an average of 19.3 months. Conclusion Signet-ring cell carcinoma of biliary tract is rare in clinic, which is commonly started from the middle aged and elderly population, the main pathological location is gallbladder, the main clinical symptoms are discomfort of right upper quadrant and jaundice, combining with cholecystitis and biliary calculus may be the related factors of morbidity, the main pathological pattern is adenocarcinoma combined with signet-ring cell carcinoma, the malignant grade is high, the patients are often in the middle and advanced stage when they are diagnosed, the operation is the main therapeutic method, the benefit of chemoradiotherapy still needs further research, the overall prognosis is bad.

Key words： Biliary tract Signet-ring cell carcinoma Pathology Prognosis

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引用本文:

夏丹丹王润洁刘超英▲. 胆道系统印戒细胞癌的临床病理特点及预后状况分析[J]. 中国医药导报, 2018, 15(2): 96-99,107.
XIA Dandan WANG Runjie LIU Chaoying▲. Analysis on clinical pathological characteristics and prognosis of signet-ring cell carcinoma of biliary tract. 中国医药导报, 2018, 15(2): 96-99,107.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I2/96

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