胆管细胞性肝癌与肝内胆管癌的临床及病理特征研究  

The clinical and pathological features of Cholangiocellular carcinoma and Intrahepatic cholangiocarcinoma

作　　者：邓敏[1] 仇毓东[1] 陈骏[1] 严笑鹏[1] 毛谅[1] 周铁[1] 

机构地区：[1]南京大学医学院附属鼓楼医院,南京210000

出　　处：《肝胆外科杂志》2015年第3期165-168,共4页Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金项目(81470866)

摘　　要：目的探讨胆管细胞性肝癌(Cholangiocellular carcinoma,Co CC)及肝内胆管癌(Intrahepatic cholangiocarcinoma,ICC)的临床、病理特点及与预后的关系。方法回顾分析2006年至2014年在南京大学医学院附属鼓楼医院肝胆胰外科手术切除的94例Co CC、ICC病例资料。其中,Co CC 28例,ICC 66例,通过术后病理鉴别ICC及Co CC,从病史及病理资料方面分析两种类型胆管癌的临床特点。结果 (1)在病史和血清学检查方面,ICC大多合并胆管结石或胆管炎病史,术前血清CA19-9较高,而Co CC则肝硬化背景较常见、术前血清AFP较高,差异有统计学意义(P<0.05)。(2)病理方面,ICC易发生神经侵犯、而Co CC肿瘤病灶数目较多等特点,差异有统计学意义(P<0.05)。ICC淋巴结转移较易发生,但差异无统计学意义(P>0.05);(3)随访两类肿瘤的中位生存期及1、3年生存率,差异虽无统计学意义,但Co CC的中位生存期较ICC长,Co CC的1、3年生存率较高。而ICC更容易在术后早期复发,差异有统计学意义(P<0.05)。结论 Co CC的临床、病理特点以及早期复发与ICC有所不同,有必要深入探讨其内在的病理机制,制定更加具有针对性的诊疗策略。Objective To investigate the clinical, pathological features of Cholangiocellular carcinoma （CoCC） and Intrahepatic cholangiocarcinoma（ ICC）, in addition to investigate the relationship between these features and prognosis. Methods 94 datum of CoCC and ICC were retrospectively analyzed in Hepatopancreatobiliary Surgery Department of the Drum Tower Hospital from 2006 to 2014. These cases were preoperatively diagnosed and pathologically proved, among which 28 were CoCC and 66 were ICC. ICC and CoCCwere identified by postoperative pathology, and the features of them were analysised through medical histories and pathological da- ta. Results （ 1 ） In medical history, ICC mostlyexist with cholangitis or bile duct stones compared to CoCC, and CA19-9 in serum is higher before operation, while the cirrhosis is more common in CoCC, and AFP in serum is higher before operation （P 〈 0. 05 ）. （2） In pathology, neural invasion occurs easily in ICC while a larger number of tumor lesions occur in CoCC （P 〈 0.05 ）, while lymph node metastasis is easier to occur in ICC, of which the difference was not statistically significant （P 〉 0. 05 ） ; （3） In follow-up data, ICC are easier to relapse in early period of postoperation, of which the difference was statistically significant （ P 〈 0. 05 ） ; Although the difference of the median survival time and 1-year and 3-year survival rates was not statistically significant in these two kinds of tumors, median survival time of CoCC is longer than that of ICC, and the 1-year and 3-year survival rate of CoCC is higher than that of ICC. Conclusion The clinical and pathological features and early recurrence of CoCC and ICC are different, it is necessary to further ex- plore the inner pathological mechanism in order to develop more targeted treatment strategies.

关 键 词：胆管癌 分类 病理 临床 区别 

分 类 号：R735.7[医药卫生—肿瘤]