CAJ | 학술논문

目的评估胆囊癌(GBC)TNM分期(AJCC第七版2010年)、手术方式与患者预后的关系.方法回顾性分析我院1998年1月至2013年6月收治的151例原发性GBC患者资料并进行统计分析.结果对于0、Ⅰ期GBC,单纯胆囊切除术组与GBC根治术组的术后生存率差异无统计学意义(x2=0.820,P=0.365);但对于Ⅱ期患者,后者的术后生存时间明显长于前者(x2 =4.151,P =0.042).在Ⅲ期患者,GBC根治术(或扩大根治术)组预后优于姑息性切除术组(均P＜0.05);而对于ⅣA期患者,前者与后者及其他治疗比较,预后差异无统计学意义.结论对于TNM 0、Ⅰ期GBC患者,单纯胆囊切除术即已达到根治目的.对Ⅱ、Ⅲ期患者应积极行GBC根治术.对于Ⅳ期GBC患者,可适当采取姑息性切除等治疗.
목적 평고담낭암(GBC)TNM분기(AJCC제칠판2010년)、수술방식여환자예후적관계.방법 회고성분석아원1998년1월지2013년6월수치적151례원발성GBC환자자료병진행통계분석.결과 대우0、Ⅰ기GBC,단순담낭절제술조여GBC근치술조적술후생존솔차이무통계학의의(x2=0.820,P=0.365);단대우Ⅱ기환자,후자적술후생존시간명현장우전자(x2 =4.151,P =0.042).재Ⅲ기환자,GBC근치술(혹확대근치술)조예후우우고식성절제술조(균P＜0.05);이대우ⅣA기환자,전자여후자급기타치료비교,예후차이무통계학의의.결론 대우TNM 0、Ⅰ기GBC환자,단순담낭절제술즉이체도근치목적.대Ⅱ、Ⅲ기환자응적겁행GBC근치술.대우Ⅳ기GBC환자,가괄당채취고식성절제등치료.
Objective To study the impact of TNM staging (AJCC,7th edition,2010) and the modes of surgical treatment on the prognosis of patients with gallbladder cancer.Methods The data of 151 patients with primary carcinoma of the gallbladder (PCG) treated in our hospital from January 1998 to June 2013 were retrospectively analyzed.Results For patients with stage 0-Ⅰ PCG,survival after radical cholecystectomy was not significantly longer than that of simple cholecystectomy (x2 =0.820,P =0.365).However,in patients with stage Ⅱ,those treated by radical cholecystectomy had significantly better prognosis than those treated by simple cholecystectomy (x2 =4.151,P =0.042).The prognosis of the radical cholecystectomy group was superior to the palliative cholecystectomy group for both stage Ⅲ A (x2 =4.511,P =0.034) and stage ⅢB (x2 =4.389,P =0.036).While in stage Ⅳ A,the difference between the radical cholecystectomy group and the palliative cholecystectomy group (including other treatment) was not significant (x2 =0.163,P =0.686).Conclusions Simple cholecystectomy is a good surgical procedure for patients with stages 0 and Ⅰ PCG,while for patients with stages Ⅱ and Ⅲ PCG,radical cholecystectomy should be carried out.For stage Ⅳ PCG,palliative treatment or other conservative treatment may be a proper treatment.