摘要目的 探讨PT1b期胆囊癌的治疗与预后.方法 16例PT1b期胆囊癌的病例人选,对比分析累积存活比率和手术相关的3个预后因素,包括手术方式、手术中胆汁溢出是否发生,手术切缘是否残留肿瘤.结果 全组单纯胆囊切除术9例(9/16),胆囊癌根治术7例;胆汁溢出发生4例(4/16),手术切缘肿瘤残留3例(3/16).多因素分析表明手术切缘是否残留肿瘤是影响预后的独立因素;Log-rank检验表明生存率与手术切缘是否阴性、胆汁溢出统计学相关(P=0.001,P=0.004),与手术方式无关(P=0.107).结论 对于PTlb期胆囊癌病人,如果术中无胆汁溢出,手术切缘肿瘤无残留能保证,单纯胆囊切除术已达到根治效果.

abstractsObjective To investigate the surgical treatment and prognosis of gallbladder carcinoma of PT1b stage. Methods Sixteen patients with gallbladder carcinoma of PT1b stage were selected. The correlation was evaluated between cumulative survival rates and the following 3 prognostic factors correlate operation: type of operation, bile spillage, tumor residual size. Results There were nine patients (9/16) accepted cholecystectomy, and 7 Radical resection. Bile spillage was found in 4 patients (4/16). Three patients (3/16) were discovered to have tumor residues in surgical margin. Multiple-factor analysis indicated that tumor residues are the independent factor affecting prognosis. Log-rank test showed that the survival rates was statistically correlated to tumor residue (P = 0. 001), and occurrence of bile spillage (P = 0.004). Survival rate did not change whether the operation was cholecystectomy or radical resection (P = 0. 107). Conclusion As for gallbladder carcinoma of PT1b stage, cholecystectomy is the curative way for long surviving if bile spillage does not occur in the operation and no tumor residue.