胰胆管合流异常与肝外胆系癌的相关性探讨
赵鑫, 李德春, 蔡 武, 刘永浩, 朱东明, 赵 华, 张子祥
中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (3) : 287-290.
胰胆管合流异常与肝外胆系癌的相关性探讨
The Correlation of pancreaticobiliary maljunction and extrahepatic biliary carcinoma
目的 探讨胰胆管合流异常与肝外胆道系统癌（胆囊癌和肝外胆管癌）的相关性。 方法 回顾性分析2008年1月～2009年12月连续857例患者行磁共振胰胆管造影的临床及影像学资料，测量其胆胰汇合角度及共同管长度，确诊胰胆管合流异常67例。随机在790例不伴有胰胆管合流异常的病例中抽取78例为对照组，与67例胰胆管合流异常的病例行对照研究，分析胰胆管合流异常与肝外胆道系统癌的相关性。 结果 67例胰胆管合流异常的患者中发生胆系癌56.72%（38例)，对照组中发生胆系癌 14.10% (11例)，两组病例中胆系癌发生率存在显著性差异（χ2=22.27, P<0.05）。胰胆管合流异常并发胆系癌的病例中，胰胆管汇合类型对胆系癌的分化程度无显著影响（χ2=2.70, P>0.05）。 结论 胰胆管合流异常与肝外胆道系统癌发生有显著相关性，而胰胆管汇合类型对胆系癌的分化程度无显著影响。
Objective To explore the correlation between pancreaticobiliary maljunction (PBM) and biliary carcinoma, including gallbladder carcinoma and extrahepatic biliary duct carcinoma. Methods We retrospectively analyzed clinical data and magnetic resonance cholangiopancreatographic results of 857 patients underwent magnetic resonance cholangiopancreatography (MRCP) in our hospital from January 2008 to December 2009. The length of common ducts and the confluence angle were measured. Eventually, 67 cases were diagnosed as PBM. In order to evaluate the correlation between PBM and extrahepatic biliary carcinoma, we randomly drew 78 cases from the 790 cases without PBM as the controls. Results 38 cases (56.72%) were diagnosed as biliary carcinoma from 67 cases of PBM, while 11 cases (14.10%) were diagnosed as biliary carcinoma in controls. The incidence of biliary carcinoma in PBM cases was significantly higher than that in no-PBM cases（χ2=22.27, P<0.05）. In cases of PBM complicated with biliary carcinoma, no correlation was found between PBM confluence types and the differentiation of biliary carcinoma（χ2=2.70, P>0.05）. Conclusions PBM is closely related to extrahepatic biliary carcinoma, however, there was no correlation between PBM confluence types and the differentiation of biliary carcinoma.
/ 胰胆管合流异常 / 磁共振胰胆管造影 / 胆系癌 / 相关性
pancreaticobiliary maljunction / magnetic resonance cholangiopancreatography / biliary carcinoma / correlation
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