中文摘要：

目的探讨原发性胆囊癌患者是否存在血管生成拟态（VM）及其VM存在的临床意义。方法收集1994年1月至2000年12月期间同济大学附属同济医院收治的74例经手术切除和病理确诊的原发性胆囊癌患者病理标本及相关临床病理参数和预后指标；应用HE染色、CD31和PAS双重染色，观察胆囊癌患者是否存在VM，并作上述相关参数的单因素分析、Kaplan—Meier生存比较和Cox风险模型分析。结果在74例胆囊癌患者中发现13．5％（10／74）存在VM。胆囊癌VM与患者性别、年龄、肿瘤部位、瘤体大小、分化程度、Nevin分期、浸润深度、局部淋巴转移无关；但与组织类型（x^2=10．241，P=0．017）、肝转移（x^2=11．904，P=0．001）和生存期（x^2=5．7221，P=0．0168）有关。Cox分析表明，VM（F=24．0508，P=0．0001，相对危险度=11．868）和浸润深度、淋巴结转移、肝转移、手术方式（姑息手术）一样，是影响胆囊癌患者预后的独立的危险因素。结论人原发性胆囊癌存在VM，有VM存在的胆囊癌患者，易发生血行转移，预后差。

英文摘要：

Objective To investigate if there is vasculagenic mimicry （VM） in human primary gallbladder carcinoma and clinical significance thereof. Methods Seventy-four specimens of primary gallbladder carcinoma obtained from operation underwent HE staining and double staining of CD31 and PAS to observe the existence of VM. The correlation of pathological examination and clinical outcomes was analyzed. Results VM was seen in 10 of the 74 （ 13.5% ） specimens. VM was not correlated with age, sex, location, diameter, differentiation degree, Nevin stage, and invasion depth of tumor, and existence of lymph node metastasis; but was associated with histological type （x^2 = 10. 241, P = 0. 017 ）, hepatic metastasis （ x^2= 11. 904, P = 0. 01 ）, and poor overall survival （ x^2 = 5.771, P = 0. 016 ）. Cox analysis showed that existence of VM, invasion depth, lymph node metastasis, hepatic metastasis, and operational method were independent risk factors of the prognosis of primary gallbladder carcinoma. Conclusion VM exists in human primary gallbladder carcinoma. Those cases of human primary gallbladder carcinoma with VM have a poorer prognosis.