手术与非手术治疗进展期肝内胆管癌疗效比较  

Surgical versus non-surgical treatment of advanced intrahepatic cholangiocarcinoma： A comparative study

作　　者：龚金龙[1] 彭创[2,3] 谭正[4] 袁文加 何翔 蒋波[2,3] 吴金术[2,3] Gong Jinlong;Peng Chuang;Tan Zheng;Yuan Wenjia;He Xiang;Jiang Bo;Wu Jinshu(Graduate School of University of South China,Hengyang 421001,China)

机构地区：[1]南华大学研究生院,湖南衡阳421001 [2]湖南省人民医院肝胆医院,410000 [3]湖南省人民医院胆道疾病研究室,410000 [4]湖南省人民医院急诊科,410000

出　　处：《中华肝胆外科杂志》2018年第10期676-680,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：湖南省科技厅科技计划项目（2009SK3079）;湖南省教育厅科学研究项目（17C0963）

摘　　要：目的比较手术与非手术治疗进展期肝内胆管癌疗效的差异，为进展期肝内胆管癌患者的临床治疗提供循证依据。方法采用回顾性队列研究的方法，收集湖南省人民医院肝胆医院及肿瘤内科2012年1月至2017年10月收治的122例进展期肝内胆管癌患者资料。行根治性手术（解剖性肝切除＋区域淋巴结清扫术）的87例患者纳入手术组；行化疗和／或放疗和／或生物靶向治疗的35例患者纳入非手术组。比较两组患者一般资料，如年龄、性别、AIJT值、AST值、CA19-9值、肝功能Child分级、AJCC分期、肿瘤个数、血管（肝动脉、门静脉）侵犯率、区域淋巴结转移率及两组患者总的生存时间等。结果两组患者在年龄、性别、ALT值、AST值、CA19-9值、肝功能Child分级、AJCC分期、肿瘤个数、血管（肝动脉、门静脉）侵犯率、区域淋巴结转移率方面的差异均无统计学意义（P〉0．05）。手术组患者总的生存时间显著长于非手术组（P〈0．05）。两组患者中位生存时间分别为32个月、15个月；1年生存率分别为74．8％、58．7％；3年生存率分别为42．4％、6．5％；5年生存率分别为12．3％、0。结论手术相对非手术治疗可以为进展期肝内胆管癌患者带来更长的中位生存时间，更高的1、3、5年生存率。Objective To compare the survival outcomes between operative versus non-operative treatment of advanced intrahepatie eholangiocarcinoma. Methods This is a retrospective study. The data from 122 patients with intrahepatie cholangioearcinoma treated at the Hunan People＇s Hospital, the Hepatobiliary Hospital and the Oncology Department from January 2012 to October 2017 were retrospective studied. 87 patients who underwent radical surgery （anatomical hepatectomy ＋ regional lymph node dissection） formed the operation group; 35 patients who were treated with chemotherapy and/or radiotherapy and/or biological targeted therapy formed the non-operative group. The general characteristics of the two groups including age, sex, ALT, AST, CA19-9, liver function, Child＇s classification, AJCC staging, tumor number, vascular （hepatic artery, portal vein） invasion and regional lymph node metastasis rates were compared. The overall survival of the two groups was compared. Results There were no significant differences in age, sex, ALT, AST, CA19-9, liver function, Child＇s classification, AJCC staging, tumor number, vascular （hepatic artery, portal vein） invasion and regional lymph node metastasis rates （P〉0.05）. The overall survival of the operation group was significantly longer than that of the non-operative group （P〈 0.05）. The mean overall survival for the 2 groups of patients were 32 months and 15 months respectively. The 1- year survival rates were 74.8% and 58.7%, and the 3 year survival rates were 42.4% and 6.5%, respectively. The 5 years survival rates were 12.3% and 0, respectively. Conclusion Operative treatment resuhed in better median survival, as well as 1-, 3- and 5-year survival rates than non-operative treatment forpatients with advanced intrahepatic cholangiocarcinoma.

关 键 词：肝内胆管癌 进展期 手术 非手术 疗效 

分 类 号：R735.8[医药卫生—肿瘤]