CAJ | 학술논문

目的总结胆囊小细胞癌(gallbladder small cell carcinoma,GSCC)的临床病理特点,探讨其诊断及治疗方法.方法回顾性分析中国医学科学院肿瘤医院2000-2012年收治的5例GSCC患者的临床及病理资料.结果 5例患者中男1例,女4例,初次就诊年龄在42 ～ 67岁(中位年龄57岁),均以非典型的右上腹疼痛、不适为初始主诉;肿瘤位于胆囊底部3例,胆囊体部2例;4例患者伴有胆石症.2例行根治性胆囊切除术,术后辅以EP(依托泊苷+顺铂)方案化疗6个周期,1例行放射治疗1次,2例患者分别随访至术后45和32个月,生存良好;3例行姑息性胆囊切除术,术后行辅助性化放疗,分别于术后8、11及30个月死于肿瘤广泛播散转移.结论 GSCC为临床少见的恶性肿瘤,初期症状不典型,确诊率低,病情进展迅速且预后相对较差;肿瘤根治切除可以显著延长患者的生存期,以手术为主的综合治疗仍是GSCC的主要治疗手段.
목적 총결담낭소세포암(gallbladder small cell carcinoma,GSCC)적림상병리특점,탐토기진단급치료방법.방법 회고성분석중국의학과학원종류의원2000-2012년수치적5례GSCC환자적림상급병리자료.결과 5례환자중남1례,녀4례,초차취진년령재42 ～ 67세(중위년령57세),균이비전형적우상복동통、불괄위초시주소;종류위우담낭저부3례,담낭체부2례;4례환자반유담석증.2례행근치성담낭절제술,술후보이EP(의탁박감+순박)방안화료6개주기,1례행방사치료1차,2례환자분별수방지술후45화32개월,생존량호;3례행고식성담낭절제술,술후행보조성화방료,분별우술후8、11급30개월사우종류엄범파산전이.결론 GSCC위림상소견적악성종류,초기증상불전형,학진솔저,병정진전신속차예후상대교차;종류근치절제가이현저연장환자적생존기,이수술위주적종합치료잉시GSCC적주요치료수단.
Objective To study the clinical features of gallbladder small cell carcinoma (GSCC),to improve the diagnosis and treatment of GSCC.Methods We retrospectively analyzed the clinical data of GSCC patients at our hospital from January 2000 to January 2012,and made a collective review of the literature.Results In this series,there were four female cases,one male case,the age at the first diagnosis was between 42-67,with the median age of 57.The main complain was pain and dis-comfort on the up and right abdomen.Tumor located in the bottom of gallbladder in 3 cases,and in the body in 2.Cholelithiasis was complicated in 4 cases.2 patients received radical resection of GSCC,followed by adjuvant chemotherapy of VP-16 and cisplatin,radioactive therapy in one.Postoperatively,these two were followed up for 45 and 32 mons with tumor free survival.3 cases received palliative resection,followed by adjuvant chemoradioactive therapy or intervention treatment,these three were followed up to 8,11,30 months respectively to their death for tumor recurrence.Conclusions GSCC is a rare disease,the initial symptoms are not often specific and easily misdiagnosed.The prognosis of GSCC is poor.