目的 探討胰腺囊腺瘤和囊腺癌的臨床病理特點及其診治。 方法 回顧性分析山東省菏澤市立醫院及曹縣人民醫院1996年6月至2007年3月共收治的17例患者的臨床病理資料。結果 本病臨床表現無特征性。B超和CT檢查能發現囊腫但不能確定類型。漿液性囊腺瘤7例均行腫瘤局部切除； 黏液性囊腺瘤6例，行胰十二指腸切除1例，胰體尾切除5例； 囊腺癌4例，行胰十二指腸切除加淋巴結清掃1例，胰體尾切除術2例，胰體尾加脾切除1例。光鏡下漿液性囊腺瘤囊壁由扁平或立方上皮細胞組成； 黏液性囊腺瘤囊壁由高柱狀上皮細胞組成，可見乳頭狀突起； 囊腺癌囊壁細胞核異形明顯，可見核分裂象及間質浸潤。15例獲得B超隨訪，中位隨訪時間為42個月（1～129個月），除1例行胰體尾切除加脾切除的老年囊腺癌患者術后6個月死于營養衰竭和 1例胰十二指腸切除患者并發糖尿病外，其余患者生存滿意，未見腫瘤復發。結論 B超和CT是本病的主要影像檢查方法。加強對本病臨床病理特征的認識是提高診治率的關鍵。手術切除治療本病療效滿意。
Ｔｈｉｒｔｅｅｎ ｃａｓｅｓ ｏｆ ｐａｎｃｒｅａｔｉｃ ｃｙｓｔ ｗｅｒｅ ａｎａｌｙｓｅｄ，ｉｎｃｌｕｄｉｎｇ ６ ｃａｓｅｓ ｏｆ ｒｅｔｅｎｔｉｏｎ ｃｙｓｔ，４ ｃａｓｅｓ ｏｆ ｃｙｓｔａｄｅｎｏｍａ ａｎｄ ３ ｃａｓｅｓ ｏｆ ｃｙｓｔａｄｅｎｏｃａｒｃｉｎｏｍａ．Ｔｈｅ ｄｉｓｅａｓｅ ｈａｓ ｎｏ ｓｐｅｃｉａｌｉｔｙ ｉｎ ｃｌｉｎｉｃａｌ ｓｙｍｐｔｏｍｓ ｕｌｔｒａｓｏｎｏｇｒａｐｈｙ ａｎｄ ＣＴ ｈａｖｅ ｈｉｇｈ ｖａｌｉｄｉｔｙ ｉｎ ｌｏｃａｔｉｎｇ ｔｈｅ ｃｙｓｔ，ｂｕｔ ｎｏ ｖａｌｕｅ ｉｎ ｄｅｔｅｒｍｉｎｇ ｉｔｓ ｐａｔｈｏｌｏｇｉｃａｌ ｎａｔｕｒｅ．Ｍｕｌｔｉｐｌｅ ｃｏｍｐａｒｔｍｅｎｔ ｏｆ ｔｈｅ ｃｙｓｔ ｗｅｒｅ ｏｆｔｅｎ ｓｅｅｎ．Ｓｅｒｏｕｓ ｆｌｕｉｄ ａｎｄ ｆｌａｔ ｅｐｉｔｈｅｌｉａｌ ｃｅｌｌ ｅｘｉｓｔｅｄ ｍａｉｎｌｙ ｉｎ ｒｅｔｅｎｔｉｏｎ ｃｙｓｔ．Ｍｕｃｉｎｏｕｓ ｆｌｕｉｄ ａｎｄ ｃｕｂｉｃ／ｃｏｌｕｍｎ ｅｐｉｔｈｅｌｉａｌ ｃｅｌｌｓ ｗｅｒｅ ａｌｗａｙｓ ｓｅｅｎ ｉｎ ｃｙｓｔａｄｅｎｏｍａ ａｎｄ ｃｙｓｔａｄｅｎｏｃａｒｃｉｎｏｍａ．Ｃｙｓｔｅｃｔｏｍｙ ｉｓ ａｎ ａｐｐｒｏｐｒｉａｔｅ ｏｐｅｒａｔｉｏｎ ｆｏｒ ｔｈｅ ｄｉｓｅａｓｅ．
Objectives To investigate the expressions and significance of E2F1, ID1, and Bax protein in gallbladder adenocarcinoma tissues. MethodsThe expressions of E2F1, ID1, and Bax protein in 70 cases of gallbladder adenocarcinoma, 20 cases of high level intraepithelial neoplasia, 30 cases of low level intraepithelial neoplasia, and 20 cases of cholecystitis tissues were tested by using immunohistochemical method. ResultsThe positive expression rates of E2F1, ID1, and Bax protein in gallbladder adenocarcinoma was 84.3%, 70.0%, and 25.7%, respectively; the positive expression rates in high level intraepithelial neoplasia was 75.0%, 65.0%, and 55.0%, respectively; the positive expression rates in low level intraepithelial neoplasia was 16.7%, 23.3%, and 56.7%, respectively; and the positive expression rates in cholecystitis tissues was 10.0%, 20.0%, and 75%, respectively.The positive expression rates of E2F1 and ID1 protein in gallbladder adenocarcinoma were significantly higher than those intraepithelial neoplasia and cholecystitis tissues (P < 0.05), but the positive expression rate of Bax protein in gallbladder adenocarcinoma was lower (P < 0.05).The expressions of E2F1 and ID1 protein were significantly correlated with clinical Nevin staging of gallbladder adenocarcinoma (P < 0.05), but not correlated with the gallbladder adenocarcinoma differentiation degree (P > 0.05).The expression of Bax protein was related to the gallbladder adenocarcinoma differentiation degree (P < 0.05), but not correlated with clinical Nevin staging (P > 0.05).The expression of E2F1 protein was negatively correlated with expression of Bax protein (r=-0.375, P < 0.05), ID1 protein expression has nothing to do with the protein expression of Bax protein (P > 0.05).The expression of E2F1 protein was positively correlated with ID1 protein (r=7.031, P < 0.05). ConclusionsThe E2F1, ID1, and Bax may play an important role in the generation and development of the gallbladder adenocarcinoma.The combined detection of E2F1, ID1, and Bax have important guiding significance for auxiliary diagnosis and clinical staging of gallbladder adenocarcinoma.
The expression of bcl-2 and p16 in 25 cases of gallbladder mucosa hyperplasia, 40 cases of gallbladder carcinoma and 25 adjacent normal gallbladder mucosa tissue was detected with immunohistochemical staining. Normal gallbladder mucosa was uniformly negative. Bcl-2 and p16 positive rate were significantly higher in hyperplasia and carcinoma than in normal tissue (Ｐ＜0.01). Expression of bcl-2 and p16 got higher with the increasing degree of hyperplasia, p16 was associated with lymph node metastasis and depth of invasion of carcinoma of the gallbladder. The results suggest that bcl-2 and p16 expression play an important role in tumorigenesis, p16 can be used as a prognostic index for gallbladder carcinoma.
To study the expressions of CA19-9 and CA125 and their clinicopathologic significancesin gallbladder adenocarcinoma , pericancerous tissues and chronic cholecystitis. Methods EnVisionTM immunohistochemist ry was used for assaying the expressive levels of CA1929 and CA125 in the routinely paraffin2embedded sections of specimens f rom gallbladder adenocarcinoma ( n = 108) , pericancerous tissues ( n = 46) , and chronic cholecystitis ( n = 35) . Results The positive rates of CA19-9 and CA125 were significantly higher in gallbladder adenocarcinoma ( 49. 1 % , 51. 9 %) than those in pericancerous tissues ( 26. 1 % , 15. 2 %) and chronic cholecystitis(14. 3 % , 5. 7 %) , respectively ( Plt; 0. 01) . The positive rates of CA19-9 and CA125 were significantly lower in thecases of adenomatous canceration , maximal diameter lt; 2 cm , no-metastasis of lymph node and no-invasion of regional tissues than those in the ones of low-differentiated adenocarcinoma , maximal diameter ≥2 cm , metastasis oflymph node and invasion of regional tissues ( Plt; 0. 05 , Plt; 0. 01 ) . The consistence of CA19-9 and CA125 expressivelevels was found in gallbladder adenocarcinoma (χ2 = 44. 69 , Plt; 0. 01) . Conclusion The expressions of CA19-9 andCA125 may be important tumor markers to reflect the carcinogenesis , progression , biological behaviors and prognosis of gallbladder adenocarcinoma.