老年人肝内胆管细胞癌临床特征  

Clinical features of intrahepatic cholangiocarcinoma in the elderly people

作　　者：吴琳[1] 张岚[1] 

机构地区：[1]复旦大学附属中山医院老年病科,上海200032

出　　处：《复旦学报（医学版）》2006年第1期128-130,132,共4页Fudan University Journal of Medical Sciences

摘　　要：目的探讨老年人肝内胆管细胞癌(ICC)的临床特征,为诊断和治疗提供临床思路。方法回顾性分析2001-2005年3月收治的25例老年患者(≥60岁)和40例非老年患者(<60岁)的临床资料并进行两组间比较。结果①老年组乙肝史和血清学HBV阳性率均低于非老年组(12%vs37.5%,40%vs67.5%,P<0.05),老年组血清总胆红素(TB)[(11.70±3.271)μmol/Lvs(15.53±6.142)μmol/L]和结合胆红素(CB)[(3.957±3.957)μmol/Lvs[5.792±3.046)μmol/L]低于非老年组(P<0.01)。两组间临床症状、血清学肿瘤标志物水平、手术切除率、淋巴结和脉管内转移率均无显著差别。②CT提示淋巴结肿大和病理提示脉管内癌栓是肿瘤转移的危险因素,其中CT提示淋巴结肿大是肿瘤转移的独立危险因素。③9例患者手术后复发,乙肝史是肿瘤复发的独立危险因素之一。结论老年组慢性乙肝患病率和血清学HBV阳性率均低于非老年组,血清TB和CB水平低于非老年组。年龄不是手术禁忌症。Purpose To study the clinical features of intrahepatic cholangiocarcinoma in the elderly people. Methods Data of 65 ICC patients were analyzed retrospectively and divided into 2 groups according to the age of the patient at diagnosis： 25 cases in the elderly group （≥60 years old） and 40 in the non-elderly group （〈60 years）. Results ①Prevalence of chronic hepatitis B and the serologic HBV positive rate were significantly lower in the elderly group than those in the non-elderly group （12% vs 37.5%, and 40% vs 67.5% respectively, P〈0.05） ,so did total bilirubin [（11.70 ± 3. 271） μmol/L vs （15.53 ±6. 142）μmol/L,P〈0.01] and combined bilirubin [（3. 957 ± 3. 957） μmol/L vs （5. 792±3. 046） μmol/L, P〈0.01] level between the two groups. No significant difference was observed in clinical manifestation, serum levels of tumor markers, treatment and lymph node metastasis or vascular cancerous embolus verified by pathology. ②Swelling of lymph nodes found on CT pictures was one of the independent risk factors of metastasis, and vascular cancerous embolus might be a risk factor. ③ Nine patients relapsed after operation within 3 years. Chronic hepatitis B was one of the independent risk factors for tumor relapse. Conclusions There were less chronic hepatitis B patients and serologic HBV positive rate in the elderly group than those in the non-elderly group. Serum level of TB and CB were lower in the elderly group. Operation should be done whenever possible and age is not a contra-index.

关 键 词：肝内胆管细胞癌 老年人 临床特征 

分 类 号：R735.8[医药卫生—肿瘤]