中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2012年
12期
893-897
,共5页
张春%李涛%董兆如%罗黎希%王钢普%姜志超%王祥宇%智绪亭
張春%李濤%董兆如%囉黎希%王鋼普%薑誌超%王祥宇%智緒亭
장춘%리도%동조여%라려희%왕강보%강지초%왕상우%지서정
胆管肿瘤%胆结石%危险因素
膽管腫瘤%膽結石%危險因素
담관종류%담결석%위험인소
Bile duct neoplasms%Cholelithiasis%Risk factors
目的 探讨肝内胆管结石合并肝内胆管癌(hepatolithiasis associated with intrahepatic cholangiocarcinoma,HLAIHCC)的临床病理特点及预后影响因素.方法 对2006年6月至2009年9月经手术治疗及病理证实的36例肝内胆管结石合并肝内胆管癌患者的临床病理特点和生存资料进行回顾性分析.结果 HLAIHCC患者的1、3、5年总生存率分别为63.6％、36.4％与30.3％,与肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)相比差异无统计学意义(65.4％、34.3％与28.6％,P=0.57).接受根治性切除术患者1、3、5年生存率分别为81.4％、61.7％与58.6％,显著优于接受姑息性手术的患者(x2=20.426,P=0.000).HLAIHCC外周血白细胞计数显著高于ICC(x2=19.700,P=0.000),肿瘤直径显著大于ICC(P=0.04)；血清CA19-9水平(P=0.049)和手术切缘(P=0.019)是影响预后的独立因素.结论 HLAIHCC具有与ICC不同的临床病理特点,根治性切除术是最有效的外科治疗方法,血清CA19-9和手术切缘是影响预后的独立因素.
目的 探討肝內膽管結石閤併肝內膽管癌(hepatolithiasis associated with intrahepatic cholangiocarcinoma,HLAIHCC)的臨床病理特點及預後影響因素.方法 對2006年6月至2009年9月經手術治療及病理證實的36例肝內膽管結石閤併肝內膽管癌患者的臨床病理特點和生存資料進行迴顧性分析.結果 HLAIHCC患者的1、3、5年總生存率分彆為63.6％、36.4％與30.3％,與肝內膽管癌(intrahepatic cholangiocarcinoma,ICC)相比差異無統計學意義(65.4％、34.3％與28.6％,P=0.57).接受根治性切除術患者1、3、5年生存率分彆為81.4％、61.7％與58.6％,顯著優于接受姑息性手術的患者(x2=20.426,P=0.000).HLAIHCC外週血白細胞計數顯著高于ICC(x2=19.700,P=0.000),腫瘤直徑顯著大于ICC(P=0.04)；血清CA19-9水平(P=0.049)和手術切緣(P=0.019)是影響預後的獨立因素.結論 HLAIHCC具有與ICC不同的臨床病理特點,根治性切除術是最有效的外科治療方法,血清CA19-9和手術切緣是影響預後的獨立因素.
목적 탐토간내담관결석합병간내담관암(hepatolithiasis associated with intrahepatic cholangiocarcinoma,HLAIHCC)적림상병리특점급예후영향인소.방법 대2006년6월지2009년9월경수술치료급병리증실적36례간내담관결석합병간내담관암환자적림상병리특점화생존자료진행회고성분석.결과 HLAIHCC환자적1、3、5년총생존솔분별위63.6％、36.4％여30.3％,여간내담관암(intrahepatic cholangiocarcinoma,ICC)상비차이무통계학의의(65.4％、34.3％여28.6％,P=0.57).접수근치성절제술환자1、3、5년생존솔분별위81.4％、61.7％여58.6％,현저우우접수고식성수술적환자(x2=20.426,P=0.000).HLAIHCC외주혈백세포계수현저고우ICC(x2=19.700,P=0.000),종류직경현저대우ICC(P=0.04)；혈청CA19-9수평(P=0.049)화수술절연(P=0.019)시영향예후적독립인소.결론 HLAIHCC구유여ICC불동적림상병리특점,근치성절제술시최유효적외과치료방법,혈청CA19-9화수술절연시영향예후적독립인소.
Objective To investigate the clinicopathological characteristics and prognostic factors of hepatolithiasis associated with intrahepatic cholangiocarcinoma (HLAIHCC).Method A ret rospective study was conducted on 36 patients who suffered from histopathologically confirmed HLAIHCC.These patients received surgical resection of the tumor from June 2006 to September 2009.Results The overall 1,3,5 year survival rates for patients with HLAIHCC were not significantly better than those patients with ICC (63.6％,36.4％,and 30.3i％ vs.65.4％,34.3％,and 28.6％,P=0.57).For the patients who received curative resection,the 1-,3-,and 5-year survival rates (81.4 ％,61.7 ％,and 58.6 ％) were significantly better than those who received palliative resections (x2 =20.426,P＜0.001).The white blood cell count was significantly higher in the HLAIHCC group than in the ICC group (x2 =19.70,P＜0.001) and tumor size was significantly smaller in the ICC group than in the HLAIHCC group (P=0.04).Serum CA19-9 level (P=0.049) and resection margin (P=0.019) were independent risk factors of prognosis.Conclusions This study showed HLAIHCC to have different clinicopathological characteristics from ICC.Curative resection was the optimal surgical treatment for HLAIHCC.Serum CA19-9 level and resection margin were independent risk factors of prognosis.
