肝门部胆管癌肿瘤直径及相关预后指标对患者预后的影响因素分析  

Influencing factor analysis of tumor diameter and related prognostic indicators on the prognosis of hilar cholangiocarcinoma

作　　者：胡海洁 靳艳文[1] 林圯昕[1] 周荣幸[1] 叶辉[1] 程南生[1] 李富宇[1] 

机构地区：[1]四川大学华西医院胆道外科,成都610041

出　　处：《中华消化外科杂志》2018年第3期266-272,共7页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金（30801111）;四川省科技计划项目（2014SZ0002-10）

摘　　要：目的：分析肝内胆管癌（ICC）临床病理特征及淋巴结转移特点。方法：采用回顾性病例对照研究方法。收集2007年4月至2017年11月国内12家医疗中心收治的1 321例［第二军医大学附属东方肝胆外科医院182例、西安交通大学第一附属医院173例、陆军军医大学（第三军医大学）第一附属医院156例、中山大学肿瘤防治中心139例、复旦大学附属中山医院128例、上海交通大学医学院附属新华医院113例、大连医科大学附属第一医院109例、天津医科大学肿瘤医院84例、郑州大学第一附属医院65例、川北医学院附属医院62例、南京大学医学院附属鼓楼医院58例、浙江大学医学院附属第二医院52例］ICC患者的临床病理资料。患者完善相关检查后，根据其临床表现及检查结果，由各医疗中心制订治疗方案，行相应手术等治疗，根据术中检查结合患者实际病情决定手术方式。观察指标：（1）实验室检查及治疗情况。（2）临床病理特征与原发肿瘤位置及直径的关系。（3）淋巴结清扫及淋巴结转移诊断情况。（4）临床病理特征与淋巴结转移的关系。符合正态分布的计量资料以±s表示，组间比较采用t检验；偏态分布的计量资料以M（范围）表示。计数资料比较采用χ2检验。结果：（1）实验室检查及治疗情况：1 321例患者中，HBV阳性202例，占15.586%（202/1 296）；血清AFP阳性（〉20 μg/L）80例，占7.339%（80/1 090）；血清CEA阳性（〉5 μg/L）329例，占26.299%（329/1 251）；血清ALT阳性（〉75 U/L）207例，占16.587%（207/1 248）；血清CA19-9阳性（〉37 U/mL）590例，占49.789%（590/1 185）；血清TBil阳性（〉20 μmol/L）300例，占24.000%（300/1 250）。1 321例患者中，1 206例施行手术治疗，其中肝切除术904例，经导管动脉内化疗栓塞术 193例，经皮经肝胆管引流 72例，内镜逆行胰胆管造影3例，经皮经肝�Objective：To analyze the clinicopathological features and lymph node metastases characteristics of intrahepatic cholangiocarcinoma （ICC）. Methods：The retrospective case-control study was conducted. The clinicopathological data of 1 321 ICC patients who were admitted to 12 hospitals from April 2007 to November 2017 were collected, including 182 in the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University, 173 in the First Affiliated Hospital of Xi′an Jiaotong University, 156 in the First Hospital Affiliated to Army Medical University （Third Military Medical University）, 139 in the Cancer Center of Sun Yat-sen University, 128 in the Zhongshan Hospital of Fudan University, 113 in the Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 109 in the First Affiliated Hospital of Dalian Medical University, 84 in the Tianjin Medical University Cancer Institute and Hospital, 65 in the First Affiliated Hospital of Zhengzhou University, 62 in the Affiliated Hospital of North Sichuan Medical College, 58 in the Affiliated Drum Tower Hospital of Nanjing University Medical School and 52 in the Second Affiliated Hospital of Zhejiang University School of Medicine. Treatment planning was respectively determined by comprehensive hospitals according to clinical features and results of related examinations. Surgical procedures were performed based on the results of intraoperative examinations and patients′ conditions. Observation indicators： （1） laboratory examination and treatment situations; （2） relationship between clinicopathological features and primary tumor location and diameter; （3） diagnosis of lymph node dissection and metastases; （4） relationship between clinicopathological features and lymph node metastases. Measurement data with normal distribution were represented as ±s, and comparison between groups was done by the t test. Measurement data with skewed distribution were described as M （range）. Comparison of count data were analyze

关 键 词：胆道肿瘤 肝门部 根治术 肿瘤直径 生存 预后因素 

分 类 号：R735.8[医药卫生—肿瘤]