原发性胆囊癌143例外科诊疗及预后影响因素分析  

Surgical diagnosis and treatment of gallbladder carcinoma and factors influencing prognosis:an analysis of 143 cases

作　　者：耿诚[1] 玉苏甫.依米提 排祖拉[1] 吐尔洪江[1] 温浩[1] 

机构地区：[1]新疆医科大学第一附属医院消化血管外科中心,新疆乌鲁木齐830054

出　　处：《中国实用外科杂志》2011年第7期602-605,共4页Chinese Journal of Practical Surgery

摘　　要：目的研究原发性胆囊癌临床特征,分析探讨影响其预后的有关因素以指导治疗。方法回顾性分析2002年1月至2008年12月间就诊于新疆医科大学第一附属医院的143例胆囊癌病人的临床、病理资料,并采用Kaplan-Meier模型、Log-rank检验及COX比例风险模型进行统计学分析。结果 143例中86例行手术治疗,行非手术治疗以及放弃治疗者57例。获得随访123例(86%),AJCCI期与Ⅱ期病人预后远好于AJCCⅢ期与Ⅳ期病人。多因素分析显示:是否存在梗阻性黄疸症状,肿瘤AJCC分期及治疗方式与胆囊癌预后显著相关。结论胆囊癌病人尽可能施行根治性手术,多种检查方法相结合以提高早期诊断率,两者均为提高胆囊癌病人预后的关键措施。Objective To investigate the clinical characteristics of primary carcinoma of the gallbladder （PCG） and discuss factors affecting prognosis for guiding treatment of PCG. Methods The clinical and pathological data of 143 cases of PCG admitted from January 2002 to December 2008 in the First Hospital of Xinjiang Medical University were analyzed retrospectively. The data were processed with statistical methods including Kaplan-Meier model, Log-rank test in univariate analysis and COX regression model in multivariate analysis. Results Among 143 cases, 86 cases were performed operation. One hundred and twenty-three cases （86%）were followed up. AJCC Ⅰ and Ⅱ stage cases had a much better prognosis than AJCC Ⅲand Ⅳ stage cases. Multivariate analysis revealed that the symptom of obstructive jaundice , AJCC stage and treatment meothod affected prognosis of PCG significantly. Conclusion Radical resection should be selected for PCG as possible. Combined examination methods can improve accuracy of early diagnosis. Both of them are key measures for improving prognosis of PCG.

关 键 词：原发性胆囊癌 预后 外科诊疗 

分 类 号：R6[医药卫生—外科学]