41例肝内胆管细胞癌的临床特点及其预后观察  

Clinical Characteristics and Prognostic Observation of Cases with Intrahepatic Cholangiocellular Carcinoma

作　　者：王晓明[1] 胡士杰[2] 吴健雄[2] 荣维淇[2] 王黎明[2] 

机构地区：[1]蓟县人民医院外科,天津市蓟县301900 [2]中国医学科学院肿瘤医院腹部外科

出　　处：《中国肿瘤临床》2006年第15期874-876,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:评价肝内胆管细胞癌的临床特点和治疗方法及预后相关因素以指导临床诊治,提高生存率。方法:分析中国医学科学院肿瘤医院1970年1月～2005年1月收治的41例肝内胆管细胞癌患者的临床资料,所有患者均获随访。结果:41例患者中AFP阳性率9.8%(4/41),肝硬化阳性率22.0%(9/41)。根治性切除组1、3、5年生存率82.3%、45.8%、45.8%;非根治性切除组1、3年生存率9.2%、0%。Cox比例风险模型多因素分析根治性切除(P<0.01)、淋巴结转移(P<0.01)、术前直接胆红素水平(P=0.012)是影响预后的独立因素。结论:肝内胆管细胞癌以手术治疗为主。根治性手术切除是获得长期生存的唯一途径。根治性切除、淋巴结转移、术前胆红素水平是影响预后的独立因素。Objective： To evaluate the clinical characteristics and different therapeutic methods for treating cholangiocellular carcinoma and to examine the factors correlated with outcome in order to guide clinical treatment and improve prognosis. Methods： Clinical data of 41 cases with cholangiocellular carcinoma from the Chinese Academy of Medical Science （CAMS） Cancer Hospital during the period from January of 1970 to January of 2005, were retrospectively reviewed. Follow up data for all patients were available. Results： In the 41 cases, the positive rate of alpha-fetoprotein （AFP） was 9.8% （4/41）, and that of liver cirrhosis was 22.0% （9/41）. In the group with radical excision, the 1-, 3- and 5-year survival rate was 82.3%, 45.8% and 45.8%, respectively, and in the group with non-radical excision, the 1- and 3-year survival rate was 9.2% and 0%. Muhifactor analysis with the Cox proportional-hazards model indicated that radical excision （P〈0.01）, lymphatic metastasis （P〈0.01） and preoperative level of direct bilirubin （P=0.012） were independent factors affecting the prognosis. Conclusion： Surgical treatment is the main therapy for intrahepatic cholangiocellular carcinoma and radical excision is the only pathway for long term survival. Radical excision, lymphatic metastasis and preoperative level of direct bilirubin are independent factors affecting the prognosis.

关 键 词：肝内胆管细胞癌 手术 预后 

分 类 号：R735.8[医药卫生—肿瘤]