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首页> 外文期刊>Surgical Endoscopy >Routine histopathology for carcinoma in cholecystectomy specimens not evidence based: A systematic review
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Routine histopathology for carcinoma in cholecystectomy specimens not evidence based: A systematic review

机译：胆囊切除术标本中的癌的常规组织病理学无证据：系统评价

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Background: Routine histopathological examination of gallbladder specimens is mainly performed to identify unexpected gallbladder carcinoma (GBC). This systematic review assesses the prevalence and characteristics of GBC in cholecystectomy specimens. Methods: PubMed, EMBASE, Web of Science, and the Cochrane Library were searched for all articles reporting on the finding of GBC in cholecystectomy specimens. Results: Of the 30 articles included, 20 were from Europe and the United States, and 10 were of Asian origin. In the Western studies, 276 cases of GBC were found in 61,542 specimens (median prevalence 0.4 %, 95 % confidence interval [CI] 0.3-0.6). Of these, 65 % were expected pre- or intraoperatively. In the Asian studies, 344 cases of GBC were found in 37,365 specimens (median prevalence 1.2 %, 95 % CI 0.8-1.7). Of these, 45 % were expected pre- or intraoperatively. In a subgroup analysis, identification of previously unexpected GBC affected treatment in only a minority of patients. In total, 72 % of the patients received no further treatment and 32 patients (22 %) received secondary surgery, of whom 15 patients survived at least 1 year. Conclusions: The histopathological finding of GBC after cholecystectomy appears to be a rare event. The prevalence of unexpected GBC was higher in Asian studies than in Western studies. The pre- and intraoperative sensitivity for this carcinoma is low. Moreover, the diagnosis of GBC at the time of histopathology is usually inconsequential. The results of this systematic review do not support routine histopathology of cholecystectomy specimens in clinical practice.
机译：背景：对胆囊标本进行常规的组织病理学检查主要是为了鉴定意外的胆囊癌（GBC）。该系统评价评估了胆囊切除术标本中GBC的患病率和特征。方法：在PubMed，EMBASE，Web of Science和Cochrane图书馆中搜索所有报道在胆囊切除术标本中发现GBC的报道。结果：纳入的30篇文章中，有20篇来自欧洲和美国，其中10篇来自亚洲。在西方研究中，在61,542个样本中发现了276例GBC（中位患病率为0.4％，95％置信区间[CI] 0.3-0.6）。其中65％的患者预计在术前或术中。在亚洲研究中，在37,365个样本中发现了344例GBC（中位患病率为1.2％，95％CI为0.8-1.7）。其中，预计有45％会在术前或术中。在亚组分析中，仅少数患者识别出先前未预期的GBC影响了治疗。总共有72％的患者未接受进一步治疗，有32例患者（22％）接受了二次手术，其中15例患者存活了至少一年。结论：胆囊切除术后GBC的组织病理学发现似乎是罕见的事件。亚洲研究中意外的GBC患病率高于西方研究。该癌的术前和术中敏感性较低。而且，在组织病理学时对GBC的诊断通常是无关紧要的。该系统评价的结果不支持临床实践中胆囊切除术标本的常规组织病理学。

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