神经浸润对肝外中远端胆管癌长期生存的影响  

Effect of nerve invasion on long term survival of middle and distal cholangiocarcinoma

作　　者：李鹏[1] 郭昊[1] 李澜滨 刘彦[1] 

机构地区：[1]辽宁省抚顺矿务局总医院普外二科,抚顺113008

出　　处：《国际外科学杂志》2017年第1期23-26,F0003,共5页International Journal of Surgery

摘　　要：目的分析肝外中远端胆管癌患者的长期生存情况，探讨神经浸润对生存期的影响。方法依据相关纳入标准回顾性分析抚顺矿务局总医院2012年1月-2016年6月收治的161例肝外中远端胆管癌患者的临床资料，依据其术后病理是否存在神经浸润分为神经组和对照组，分析比较两组患者术前一般资料、围手术期资料及长期生存情况。结果所有患者均顺利完成手术，神经浸润的发病率为47．2％（76／161），神经浸润更多见于远端胆管癌和Ⅱ期胆管癌。围手术期患者的病死率为3．7％（6／161），并发症发病率为27．3％（44／161）。中远端胆管癌患者的总体1年、2年、3年生存率分别为78．7％、42．1％、20．0％，中位生存时间为（23．8±1．2）个月。神经组和对照组患者的1年、2年、3年生存率分为67．1％、29．8％、9．4％和89．0％、52．6％、26．8％，平均生存时间分别为（18．6±1．4）个月和（27．3±1．6）个月。神经浸润患者的预后明显低于无神经浸润患者（P〈0．05）。结论神经浸润是中远端胆管癌常见的一种侵犯转移方式，对于已发生神经浸润的胆管癌患者，其总体预后较差。Objective To analyze the long-term survival of patients with middle and distal cholangiocarcinoma, and to explore the influence of nerve invasion on the survival time. Methods We retrospectively analyzed the clinical data of 161 patients with middle or distal cholangiocarcinoma in General Hospital of Fushun Mining Bureau between January 2012 and June 2016. All the patients were divided into nerve group and control group according to the nerve invasion. And then the perioperative and prognosis data of the two groups were analyzed and compared. Results In our fesearch, all patients were successfully completed surgery, the incidence of neural invasion was 47. 2% （76/161）, more common of the nerve invasion in distal cholangiocarcinoma and phase Ⅱ cholangiocarcinoma. The perioperative mortality rate was 3.7% （6/161）, and the incidence of complications was 27.3% （44/161）. The 1 years, 2 years and 3 years survival rates of middle and distal cholangiocarcinoma were 78.7% , 42.1% , 20.0% , the average survival time was（23.8 ± 1.2） months. The 1 years, 2 years and 3 years survival rates of nerve group and control group were 67.1% , 29.8% , 9.4% and 89.0% , 52.6% , 26.8% , the average smwival time were （ 18.6 ± 1.4） months and （27.3 ± 1.6） months. The prognosis of nerve group was significantly poor than the control group （ P 〈 0.05 ）. Corleluslons Nerve invasion is a common way of invasion and metastasis of cholangiocarcinoma. And it has a poor prognosis in cholangiocarcinoma patients with nerve invasion.

关 键 词：胆管肿瘤 神经 浸润 预后 

分 类 号：R735.8[医药卫生—肿瘤]