Korean Journal of Gastrointestinal Endoscopy 2005;30(1): 12-18.
담낭벽 비후를 보이는 담낭 병변의 악, 양성 감별진단에 있어서 예측인자가 되는 내시경초음파검사 소견에 대한 연구
이 돈·이성구·김명환·서동완·이상수·민영일·김정선*
울산대학교 의과대학 서울아산병원 내과, *병리과
Endosonographic Findings Useful in the Differentiation between Malignant and Benign Causes of Thickened Gallbladder Wall
Don Lee, M.D., Sung Koo Lee, M.D., Myung-Hwan Kim, M.D., Dong Wan Seo, M.D., Sang Soo Lee, M.D., Young Il Min, M.D. and Jung-Sun Kim, M.D.*
Departments of Internal Medicine, and *Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract
Background/Aims: The early diagnosis of possible cancer in thickened gallbladder wall is very important. This study was aimed to confirm the usefulness of endoscopic ultrasonography in differential diagnosis of gallbladder cancer in thickened gallbladder wall, and to find out the findings of endoscopic ultrasonography which favor malignancy. Methods: We reviewed 67 cases of patients who underwent cholecystectomies and who also showed thickened gallbladder wall in their preoperative endoscopic ultrasonography. According to the post-surgical pathologic diagnosis, the cases were classified into malignant and benign diseases, and they were statistically compared with several findings of endoscopic ultrasonography of thickened gallbladder wall. Results: Pathologic diagnosis included 10 cancers and 57 benign diseases. The sensitivity (90%) and specificity (98%) of endoscopic ultrasonography for diagnosis of gallbladder cancer were superior to those of other techniques. Wall thickness, associations of gallstones, loss or preservation of layered structure and irregularity of inner surface of thickened wall were significant variables in the differential diagnosis between malignant and benign causes of thickened gallbladder wall (p＜0.05). Conclusions: Endoscopic ultrasonography is useful to diagnose gallbladder cancer within thickened wall. Loss of layered structure and irregular inner surface of thickened wall are independent predictive factor of gallbladder cancer. (Korean J Gastrointest Endosc 2005;30: 1218)
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