中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2011年
2期
73-76
,共4页
殷欣%张博恒%陈晓泓%任正刚%叶胜龙
慇訢%張博恆%陳曉泓%任正剛%葉勝龍
은흔%장박항%진효홍%임정강%협성룡
癌,肝细胞%胆管肿瘤%胆管,肝内%淋巴转移%预后%肿瘤分期
癌,肝細胞%膽管腫瘤%膽管,肝內%淋巴轉移%預後%腫瘤分期
암,간세포%담관종류%담관,간내%림파전이%예후%종류분기
Carcinoma,hepatocellular%Bile duct neoplasms%Bile ducts,intrahepatic%Lymphatic metastasis%Progriosis%Neoplasm staging
目的 研究混合型肝癌的临床病理特征及预后.方法 收集复旦大学肝癌研究所1995年至2007年经病理检查确诊的115例混合型肝癌患者临床病理及随访资料,分析混合型肝癌的临床病理特征.以Kaplan-Meier法计算患者1、3、5年生存率及无瘤生存率并行Log-rank法分析,探讨与混合型肝癌预后相关的影响因素.结果 115例患者中Allen A型和B型各1例,其余113例均为C型.患者以男性为主,多伴肝硬化,可出现甲胎蛋白水平升高、CA19-9水平升高、门静脉系统血管侵犯、包膜不完整、淋巴结转移等表现.115例患者的1、3、5年总体生存率分别为68.1%、38.1%、33.6%,中位生存时间为13.0个月.行根治性切除术者1、3、5年总体生存率分别为78.4%、44.4%、44.4%,中位生存时间为16.0个月;无瘤生存率分别为57.8%、12.6%、0.0%,中位复发时间为10.0个月.10例非手术治疗者1、3、5年总体生存率分别为1/10、0/10、0/10,中位生存时间为5.3个月.TNM分期是患者术后生存的独立影响因素,淋巴结转移是患者根治性切除术后无瘤生存的独立影响因素.结论 混合型肝癌临床病理特征接近肝细胞癌,但预后较肝细胞癌差.TNM分期是患者术后生存的独立影响因素.
目的 研究混閤型肝癌的臨床病理特徵及預後.方法 收集複旦大學肝癌研究所1995年至2007年經病理檢查確診的115例混閤型肝癌患者臨床病理及隨訪資料,分析混閤型肝癌的臨床病理特徵.以Kaplan-Meier法計算患者1、3、5年生存率及無瘤生存率併行Log-rank法分析,探討與混閤型肝癌預後相關的影響因素.結果 115例患者中Allen A型和B型各1例,其餘113例均為C型.患者以男性為主,多伴肝硬化,可齣現甲胎蛋白水平升高、CA19-9水平升高、門靜脈繫統血管侵犯、包膜不完整、淋巴結轉移等錶現.115例患者的1、3、5年總體生存率分彆為68.1%、38.1%、33.6%,中位生存時間為13.0箇月.行根治性切除術者1、3、5年總體生存率分彆為78.4%、44.4%、44.4%,中位生存時間為16.0箇月;無瘤生存率分彆為57.8%、12.6%、0.0%,中位複髮時間為10.0箇月.10例非手術治療者1、3、5年總體生存率分彆為1/10、0/10、0/10,中位生存時間為5.3箇月.TNM分期是患者術後生存的獨立影響因素,淋巴結轉移是患者根治性切除術後無瘤生存的獨立影響因素.結論 混閤型肝癌臨床病理特徵接近肝細胞癌,但預後較肝細胞癌差.TNM分期是患者術後生存的獨立影響因素.
목적 연구혼합형간암적림상병리특정급예후.방법 수집복단대학간암연구소1995년지2007년경병리검사학진적115례혼합형간암환자림상병리급수방자료,분석혼합형간암적림상병리특정.이Kaplan-Meier법계산환자1、3、5년생존솔급무류생존솔병행Log-rank법분석,탐토여혼합형간암예후상관적영향인소.결과 115례환자중Allen A형화B형각1례,기여113례균위C형.환자이남성위주,다반간경화,가출현갑태단백수평승고、CA19-9수평승고、문정맥계통혈관침범、포막불완정、림파결전이등표현.115례환자적1、3、5년총체생존솔분별위68.1%、38.1%、33.6%,중위생존시간위13.0개월.행근치성절제술자1、3、5년총체생존솔분별위78.4%、44.4%、44.4%,중위생존시간위16.0개월;무류생존솔분별위57.8%、12.6%、0.0%,중위복발시간위10.0개월.10례비수술치료자1、3、5년총체생존솔분별위1/10、0/10、0/10,중위생존시간위5.3개월.TNM분기시환자술후생존적독립영향인소,림파결전이시환자근치성절제술후무류생존적독립영향인소.결론 혼합형간암림상병리특정접근간세포암,단예후교간세포암차.TNM분기시환자술후생존적독립영향인소.
Objective To assess clinicopathological features and prognosis of patients with combined hepatocellular and cholangiocarcinoma (cHCC-CC). Methods Clinicopathological and follow-up data of 115 cHCC-CC patients confirmed pathologically in Liver Cancer Institute of Fudan University from 1995 to 2007 were analyzed. Kaplan-Meier method was used to calculate 1-,3- and 5-year survival rates and tumor-free survival rates. Survival curves were analyzed using the log-rank test. The factors that impacted the prognosis of cHCC-CC were estimated. Results In 115 cases, one was Allen's type A, one was Allen's type B, and the other 113 were Allen's type C. Being with male in predominance, most of the cHCC-CC patients had liver cirrhosis background. They presented with elevated AFP or CA19-9, vascular invasion, resembling hepatocellular carcinoma(HCC)as well as lymph nodes metastasis. One-, 3-, 5-year survival rates of 115 patients were 68. 1%, 38. 1% and 33.6%, respectively, with median survival time of 13.0 months. Whereas the 1-, 3-, 5-year survival rates in radical resected patients were 78.4 % ,44.4 % and 44.4 % ,respectively, with median survival time of 16.0 months. Tumor free survival time at 1-, 3- and 5-year was 57.8 %, 12.6 % and 0.0 %,respectively,with median recurrent time of 10.0 months. One-, 3-, 5-year survival rates of 10 nonsurgical patients were 10/10,10/10 and 0/10,respectively, with median survival time of 5.3 months.TNM stage was independent factor for prognosis of the patients after resection. Whereas the lymph nodes involvement was independent factor for the tumor free survival time of radical resected patients.Conclusions Although clinicopathological characteristics of cHCC-CC are more similar to those of HCC, the prognosis of cHCC-CC is more unfavorable than that of HCC. TNM stage is an independent determinant of long time outcome for patients after resection.
