CAJ | 학술논문

目的：探讨β-连环蛋白及其他因素对术前评估可手术切除的肝内胆管细胞癌预后的影响。方法选择189例术前评估可手术切除的肝内胆管细胞癌患者为研究对象，回顾性分析手术治疗的临床、病理及随访资料，单因素及多因素回归分析影响预后的相关因素。结果R0、R1、R2及探查取活检术患者分别为63例、84例、31例及11例。R0、R1、R2及探查取活检术患者的5年生存率分别为26．3％、14．3％、6．8％和0％，189例患者的5年生存率为16．8％。多因素分析表明切缘阳性、多个肿瘤、β-连环蛋白阳性表达、淋巴结转移是预后差的独立预测因素。结论肝内胆管细胞癌手术时尽管 R0切除的比例较低，但 R0切除的预后最佳。β-连环蛋白阳性表达、多个肿瘤及淋巴结转移的肝内胆管细胞癌患者预后差，对此部分患者手术切除是否适宜值得进一步探讨。
목적：탐토β-련배단백급기타인소대술전평고가수술절제적간내담관세포암예후적영향。방법선택189례술전평고가수술절제적간내담관세포암환자위연구대상，회고성분석수술치료적림상、병리급수방자료，단인소급다인소회귀분석영향예후적상관인소。결과R0、R1、R2급탐사취활검술환자분별위63례、84례、31례급11례。R0、R1、R2급탐사취활검술환자적5년생존솔분별위26．3％、14．3％、6．8％화0％，189례환자적5년생존솔위16．8％。다인소분석표명절연양성、다개종류、β-련배단백양성표체、림파결전이시예후차적독립예측인소。결론간내담관세포암수술시진관 R0절제적비례교저，단 R0절제적예후최가。β-련배단백양성표체、다개종류급림파결전이적간내담관세포암환자예후차，대차부분환자수술절제시부괄의치득진일보탐토。
Objective To assess these in a consecutive series of patients with ICC treated surgically. Methods A retrospective study was conducted on 189 ICC patients undergoing surgery.Surgical results and survival were evaluated and compared among different subgroups of patients.Univariate and multivariate analyses were performed to identify prognostic factors.Results R0,R1,R2 resection and exploratory laparotomy were obtained in 63,84,31 and 11 patients,respectively.The overall 5 -year survival rates for the entire cohort were 16.8%,with corresponding rates of 26.3% for patients with R0 resection;14.3% for patients with R1 resection;6.8% for patients with R2 resection;and 0.0% for patients with an exploratory laparotomy.Independent factors for poor survival included positive resection margin,multiple tumors,beta - catenin nuclear expression and lymph node metastasis. Conclusion R0 resection offers the best possibility of long -term survival,but the chance of a R0 resection is low when surgery is performed for potential resectable ICC.Patients with characteristics of beta -catenin nuclear expres-sion,multiple tumors and lymph node metastasis are indicated to surgery which is needed to be further studied.