实用肿瘤学杂志
實用腫瘤學雜誌
실용종류학잡지
JOURNAL OF PRACTICAL ONCOLOGY
2015年
3期
203-207
,共5页
刘钦兰%闫晓杰%夏学明%白莉
劉欽蘭%閆曉傑%夏學明%白莉
류흠란%염효걸%하학명%백리
肝门部胆管癌%生存分析%预后因素
肝門部膽管癌%生存分析%預後因素
간문부담관암%생존분석%예후인소
Hilar cholangiocarcinoma%Survival data analysis%Prognosis factors
目的:探讨经手术治疗的肝门部胆管癌患者的临床特点及与预后相关的因素。方法回顾性分析58例行手术治疗的肝门部胆管癌患者的临床资料,应用Kaplan-Meier法计算生存率,对可能影响患者预后的因素分别进行单因素分析( Log-rank检验),应用Cox比例风险模型进行多因素统计分析。结果58例肝门部胆管癌患者的中位生存时间为22.00个月,1年、3年、5年生存率分别为76%、40%和21%。单因素分析表明术前血清白蛋白( P=0.002)、术中出血量( P=0.039)、手术方式( P=0.006)、分化程度(P=0.001)、是否侵及门静脉(P=0.014)、手术切缘有无癌细胞(P=0.020)对患者的术后生存时间有显著性影响。多因素分析结果显示手术方式(P=0.022)、肿瘤分化程度(P=0.020)是影响患者生存的独立预后因素。结论术前血清白蛋白低于35 g/L、术中出血量大于>500 mL、肿瘤低分化、门静脉浸润、根治性切除( R0)、手术切缘癌细胞阳性是影响肝门部胆管癌患者预后的危险因素。
目的:探討經手術治療的肝門部膽管癌患者的臨床特點及與預後相關的因素。方法迴顧性分析58例行手術治療的肝門部膽管癌患者的臨床資料,應用Kaplan-Meier法計算生存率,對可能影響患者預後的因素分彆進行單因素分析( Log-rank檢驗),應用Cox比例風險模型進行多因素統計分析。結果58例肝門部膽管癌患者的中位生存時間為22.00箇月,1年、3年、5年生存率分彆為76%、40%和21%。單因素分析錶明術前血清白蛋白( P=0.002)、術中齣血量( P=0.039)、手術方式( P=0.006)、分化程度(P=0.001)、是否侵及門靜脈(P=0.014)、手術切緣有無癌細胞(P=0.020)對患者的術後生存時間有顯著性影響。多因素分析結果顯示手術方式(P=0.022)、腫瘤分化程度(P=0.020)是影響患者生存的獨立預後因素。結論術前血清白蛋白低于35 g/L、術中齣血量大于>500 mL、腫瘤低分化、門靜脈浸潤、根治性切除( R0)、手術切緣癌細胞暘性是影響肝門部膽管癌患者預後的危險因素。
목적:탐토경수술치료적간문부담관암환자적림상특점급여예후상관적인소。방법회고성분석58례행수술치료적간문부담관암환자적림상자료,응용Kaplan-Meier법계산생존솔,대가능영향환자예후적인소분별진행단인소분석( Log-rank검험),응용Cox비례풍험모형진행다인소통계분석。결과58례간문부담관암환자적중위생존시간위22.00개월,1년、3년、5년생존솔분별위76%、40%화21%。단인소분석표명술전혈청백단백( P=0.002)、술중출혈량( P=0.039)、수술방식( P=0.006)、분화정도(P=0.001)、시부침급문정맥(P=0.014)、수술절연유무암세포(P=0.020)대환자적술후생존시간유현저성영향。다인소분석결과현시수술방식(P=0.022)、종류분화정도(P=0.020)시영향환자생존적독립예후인소。결론술전혈청백단백저우35 g/L、술중출혈량대우>500 mL、종류저분화、문정맥침윤、근치성절제( R0)、수술절연암세포양성시영향간문부담관암환자예후적위험인소。
Objective To investigate the clinical characteristics and its prognostic factors for hilar cholangiocarcinoma with exairesis .Methods The clinical data of 58 cases of hilar cholangiocarcinoma were ret-rospectively analyzed .The Kaplan-Meier method was used to estimate the overall survival and disease specific survival rates for these patients .And the factors that may influence the prognosis and survival of patients were an -alyzed using univariate(log-rank test)and multivariate Cox proportional hazard models .Results The median survival time was 22 months for all patients .The 1-,3-and 5-year survival rates were 76%,40%and 21%, respectively.Univariate analysis showed that preoperative albumin (P=0.002),intraoperative blood loss (P=0.039),surgical method(P =0.006),histologic differentiation(P =0.001),portal vein encroached(P =0.014),surgical margin(P=0.020)were correlated factors for postoperative survival duration .Multivariate analy-sis by Cox Proportional Hazard Model showed that surgical method (P=0.022),histologic differentiation(P=0.020)were independent prognostic factors for patients with Hilar cholangiocarcinoma excised .Conclusion Low albumin leve,intraoperative blood loss more than 500 mL,low degree of tumor differentiation,portal vein en-croached ,radical surgery ,positive surgical margin are risk factors for total survival of Hilar cholangiocarcinoma .