胆囊癌早期诊断的临床探讨
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摘要
目的分析探讨胆囊癌早期诊断的临床价值。方法方便选取2011年11月—2016年11月收治的19例胆囊癌患者,回顾性分析所有患者的临床资料以及具体的治疗方式。结果胆囊癌少见且与胆囊结石、胆息肉之间具有较大的关联性,所有患者均进行磁共振、CT以及B超检查,磁共振检查诊断准确率为52.62%,CT诊断准确率为47.3%,B超诊断准确率为57.89%,均接受手术治疗,9例患者术前确诊为胆囊癌,确诊率为56.25%;6例考虑胆囊癌可能,占31.57%。3例术中诊断为胆囊癌,确诊率为15.78%。结论对早期胆囊癌患者的诊断难度较大,应对胆囊癌早期症状与发病机制重要性加强认识,联合使用CT、B超等多种检查手段,及早发现患者病情。
Objective To analyze the clinical value of early diagnosis of gallbladder cancer. Methods 19 patients with gallbladder cancer admitted from November 2011 to November 2016 were convenient retrospectively analyzed for clinical data and specific treatment modalities. Results Gallbladder carcinoma was rare and had a strong correlation with gallstones and bile polyps. All patients underwent magnetic resonance, CT and B-ultrasound examination. The diagnostic accuracy of magnetic resonance imaging was 52.62%, and the diagnostic accuracy of CT was 47.3%, B ultrasound diagnosis accuracy rate of57.89%, were treated with surgery, 9 patients diagnosed as gallbladder cancer before surgery, the diagnosis rate was56.25%; 6 cases considered gallbladder cancer may account for 31.57%. Three cases were diagnosed as gallbladder cancer,and the diagnosis rate was 15.78%. Conclusion It is difficult to diagnose patients with early gallbladder cancer. It should strengthen the understanding of the early symptoms and pathogenesis of gallbladder cancer, and use CT, B-ultrasound and other examination methods to detect the patient's condition early.
Objective To analyze the clinical value of early diagnosis of gallbladder cancer. Methods 19 patients with gallbladder cancer admitted from November 2011 to November 2016 were convenient retrospectively analyzed for clinical data and specific treatment modalities. Results Gallbladder carcinoma was rare and had a strong correlation with gallstones and bile polyps. All patients underwent magnetic resonance, CT and B-ultrasound examination. The diagnostic accuracy of magnetic resonance imaging was 52.62%, and the diagnostic accuracy of CT was 47.3%, B ultrasound diagnosis accuracy rate of57.89%, were treated with surgery, 9 patients diagnosed as gallbladder cancer before surgery, the diagnosis rate was56.25%; 6 cases considered gallbladder cancer may account for 31.57%. Three cases were diagnosed as gallbladder cancer,and the diagnosis rate was 15.78%. Conclusion It is difficult to diagnose patients with early gallbladder cancer. It should strengthen the understanding of the early symptoms and pathogenesis of gallbladder cancer, and use CT, B-ultrasound and other examination methods to detect the patient's condition early.
引文
[1]张航宇,窦科峰.超声联合肿瘤标志物CA19-9及超敏C反应蛋白检测对胆囊癌早期诊断准确性的影响[J].解放军医学杂志,2015,39(3):222-225.
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[3]徐贵川,申霞,周呈义.螺旋CT对黄色肉芽肿性胆囊炎与厚壁型胆囊癌的诊断及鉴别价值观察[J].临床医药文献电子杂志,2017,4(31):6056-6057.
[4]郑继伟.彩色多普勒超声诊断胆囊癌和胆结石相关性的效果观察[J].大家健康:学术版,2016,10(9):65-66.
[5]杨明.螺旋CT技术在胆囊癌诊断及鉴别诊断中的价值探讨[J].中国处方药,2016,14(6):118-119.
[6]龚志高.CT和MRI对中晚期胆囊癌周围脏器侵袭和转移的诊断价值[J].中国医药指南,2016,14(19):163-164.
[7]陈静.磁共振成像在原发性胆囊癌早期诊断中的应用价值探讨[J].黑龙江医学,2016,40(8):771-772.
[8]张小杉,冯天鹰,哈斯.彩色能量多普勒超声在胆囊癌早期诊断中的应用价值[J].内蒙古医学杂志,2006(12):1116-1118.
[9]孙家骏,景鸿恩,郭新建,等.ras和p53基因在原发性胆囊癌早期诊断中的应用研究[J].中华肝胆外科杂志,2015(7)30-32.
[10]王彦峰.胆囊癌的早期治疗及预后影响因素分析[J].现代诊断与治疗,2015,26(2):257-258.
[2]高磊,谌松霖,王光霞.超声联合CA19-9及CEA检测对胆囊癌早期诊断准确性的影响[J].中国中西医结合外科杂志,2017,23(3):239-242.
[3]徐贵川,申霞,周呈义.螺旋CT对黄色肉芽肿性胆囊炎与厚壁型胆囊癌的诊断及鉴别价值观察[J].临床医药文献电子杂志,2017,4(31):6056-6057.
[4]郑继伟.彩色多普勒超声诊断胆囊癌和胆结石相关性的效果观察[J].大家健康:学术版,2016,10(9):65-66.
[5]杨明.螺旋CT技术在胆囊癌诊断及鉴别诊断中的价值探讨[J].中国处方药,2016,14(6):118-119.
[6]龚志高.CT和MRI对中晚期胆囊癌周围脏器侵袭和转移的诊断价值[J].中国医药指南,2016,14(19):163-164.
[7]陈静.磁共振成像在原发性胆囊癌早期诊断中的应用价值探讨[J].黑龙江医学,2016,40(8):771-772.
[8]张小杉,冯天鹰,哈斯.彩色能量多普勒超声在胆囊癌早期诊断中的应用价值[J].内蒙古医学杂志,2006(12):1116-1118.
[9]孙家骏,景鸿恩,郭新建,等.ras和p53基因在原发性胆囊癌早期诊断中的应用研究[J].中华肝胆外科杂志,2015(7)30-32.
[10]王彦峰.胆囊癌的早期治疗及预后影响因素分析[J].现代诊断与治疗,2015,26(2):257-258.