Clinical characteristics of squamous cell carcinoma and adenosquamous cell carcinoma of the gallbladder: An analysis of 25 cases

doi:10.3877/cma.j.issn.1674-0793.2023.02.006

Abstract

Abstract:

Objective

To summarize the clinical manifestations, pathological characteristics and treatment of squamous cell carcinoma (SC) and adenosquamous cell carcinoma (ASC) of the gallbladder.

Methods

A total of 25 patients with SC/ASC in Peking Union Medical College Hospital from January 2003 to December 2021 were retrospectively analyzed. Baseline information, clinical manifestations, serology, radiological examination, surgical information and pathological characteristics were collected.

Results

In the 25 cases, 5 were SC and 20 were ASC. 21 patients (84.0%) presented with nonspecific abdominal pain as the first symptom. All patients had normal bilirubin. 5 patients (20.0%) had elevated alanine aminotransferase (ALT). 9 patients (36.0%) had elevated gamma-glutamyl transferase (GGT) and alkaline phosphatases (ALP). SC/ASC usually showed local invasive growth without lymph node metastasis on CT scan. 19 patients (76.0%) underwent radical gallbladder resection. 3 patients (12.0%) underwent palliative cholecystectomy. 3 patients (12.0%) were incidentally diagnosed by postoperative pathology of gallstones. The incidence of lymph node metastasis between SC and ASC were 0 and 69.2%, respectively (P=0.143). There was no significant difference in the proportion of poor differentiation between SC and ASC (20.0% vs 45.0%, P=0.615).

Conclusion

SC and ASC of gallbladder are invasive cancer, difficult in early diagnosis, and radical surgical resection is the preferred treatment.

Key words: Squamous cell carcinoma of the gallbladder, Adenosquamous cell carcinoma of the gallbladder, Cholecystectomy

Cuiting Wu, Yuan Xu, Qi Liu, Jianchun Xiao, Wei Liu, Jing Wang, Qiang Qu. Clinical characteristics of squamous cell carcinoma and adenosquamous cell carcinoma of the gallbladder: An analysis of 25 cases[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(02): 115-118.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2023.02.006

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References 7

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序号	年龄(岁)	性别	肿瘤最大径(cm)	胆囊管受累	临近脏器受累	手术方式	切除情况	病理类型	胆囊结石
1	67	女	6	有	肝	胆囊+胆囊床部分肝组织切除	R1	SC	有
2	79	女	5.5	无	肝	胆囊+胆囊床部分肝组织切除	R0	ASC	无
3	69	女	1.5	无	无	腹腔镜胆囊切除	R1	ASC	有
4	41	女	7	无	肝	胆囊+肝方叶切除	R0	ASC	无
5	81	男	2	无	无	腹腔镜胆囊切除	R0	SC	有
6	38	男	3	无	无	腹腔镜胆囊切除	R0	ASC	无
7	64	男	6	无	肝	胆囊+肝方叶切除	R0	ASC	有
8	68	男	9	有	肝	胆囊+肝方叶切除	R1	ASC	无
9	57	男	5.2	有	肝	姑息性胆囊切除、胆管内支架植入	R2	ASC	无
10	72	女	4.5	有	肝	胆囊+胆囊床部分肝组织切除	R1	SC	有
11	57	男	6	无	肝	胆囊+肝方叶切除	R0	ASC	无
12	68	男	1.5	无	无	胆囊+胆囊床部分肝组织切除	R0	SC	有
13	75	男	8	有	肝、右半结肠、十二指肠球部、胃窦	胆囊+肝方叶切除	R1	ASC	有
14	44	男	6.5	有	肝、大网膜、肝十二指肠韧带、胃前壁	胆囊+肝方叶切除	R1	ASC	无
15	60	女	5	有	肝、结肠、直肠、脾、膈肌、肚脐、子宫、双卵巢、左卵管、双侧宫骶韧带	胆囊及周围脏器广泛切除	R1	ASC	有
16	71	女	4	有	外周脂肪	姑息性胆囊切除	R2	ASC	无
17	69	女	2.1	有	外周脂肪	胆囊+胆总管切除、胆肠吻合	R1	ASC	有
18	65	女	1.2	无	无	腹腔镜胆囊切除	R0	ASC	有
19	71	男	8	无	肝	胆囊+肝方叶切除	R1	ASC	有
20	61	女	1.2	无	肝	胆囊+胆囊床部分肝组织切除	R0	SC	有
21	67	男	5.2	有	肝	胆囊+胆总管切除、胆肠吻合	R0	ASC	无
22	65	男	6	无	外周脂肪	姑息性胆囊切除	R2	ASC	无
23	68	女	1.5	有	肝、胃、胰腺	胆囊及周围脏器广泛切除	R1	ASC	无
24	42	女	10	无	肝	胆囊+肝方叶切除	R1	ASC	无
25	62	女	4.5	无	肝	胆囊+肝方叶切除	R0	ASC	无

序号	年龄(岁)	性别	肿瘤最大径(cm)	胆囊管受累	临近脏器受累	手术方式	切除情况	病理类型	胆囊结石
1	67	女	6	有	肝	胆囊+胆囊床部分肝组织切除	R1	SC	有
2	79	女	5.5	无	肝	胆囊+胆囊床部分肝组织切除	R0	ASC	无
3	69	女	1.5	无	无	腹腔镜胆囊切除	R1	ASC	有
4	41	女	7	无	肝	胆囊+肝方叶切除	R0	ASC	无
5	81	男	2	无	无	腹腔镜胆囊切除	R0	SC	有
6	38	男	3	无	无	腹腔镜胆囊切除	R0	ASC	无
7	64	男	6	无	肝	胆囊+肝方叶切除	R0	ASC	有
8	68	男	9	有	肝	胆囊+肝方叶切除	R1	ASC	无
9	57	男	5.2	有	肝	姑息性胆囊切除、胆管内支架植入	R2	ASC	无
10	72	女	4.5	有	肝	胆囊+胆囊床部分肝组织切除	R1	SC	有
11	57	男	6	无	肝	胆囊+肝方叶切除	R0	ASC	无
12	68	男	1.5	无	无	胆囊+胆囊床部分肝组织切除	R0	SC	有
13	75	男	8	有	肝、右半结肠、十二指肠球部、胃窦	胆囊+肝方叶切除	R1	ASC	有
14	44	男	6.5	有	肝、大网膜、肝十二指肠韧带、胃前壁	胆囊+肝方叶切除	R1	ASC	无
15	60	女	5	有	肝、结肠、直肠、脾、膈肌、肚脐、子宫、双卵巢、左卵管、双侧宫骶韧带	胆囊及周围脏器广泛切除	R1	ASC	有
16	71	女	4	有	外周脂肪	姑息性胆囊切除	R2	ASC	无
17	69	女	2.1	有	外周脂肪	胆囊+胆总管切除、胆肠吻合	R1	ASC	有
18	65	女	1.2	无	无	腹腔镜胆囊切除	R0	ASC	有
19	71	男	8	无	肝	胆囊+肝方叶切除	R1	ASC	有
20	61	女	1.2	无	肝	胆囊+胆囊床部分肝组织切除	R0	SC	有
21	67	男	5.2	有	肝	胆囊+胆总管切除、胆肠吻合	R0	ASC	无
22	65	男	6	无	外周脂肪	姑息性胆囊切除	R2	ASC	无
23	68	女	1.5	有	肝、胃、胰腺	胆囊及周围脏器广泛切除	R1	ASC	无
24	42	女	10	无	肝	胆囊+肝方叶切除	R1	ASC	无
25	62	女	4.5	无	肝	胆囊+肝方叶切除	R0	ASC	无

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