基于优势肿瘤细胞分组的混合型肝癌的临床特征和预后研究  

Clinical characteristics and prognosis of combined hepatocellular cholangiocarcinoma based on dominant tumor cell grouping

作　　者：张浩[1] 李娟[2] 俞小炯[1] 许建[1] 董科[1] 汪旭[1] Hao Zhang;Juan Li;Xiao-jiong Yu;Jian Xu;Ke Dong;Xu Wang(Department of Hepatobiliary Surgery,Sichuan Provincial People’s Hospital(Affiliated Hospital of University of Electronic Science and Technology of China),Chengdu,Sichuan 610072,China;Department of Pathology,Sichuan Provincial People’s Hospital(Affiliated Hospital of University of Electronic Science and Technology of China),Chengdu,Sichuan 610072,China)

机构地区：[1]四川省人民医院(电子科技大学附属医院)肝胆外科,四川成都610072 [2]四川省人民医院(电子科技大学附属医院)病理科,四川成都610072

出　　处：《中国现代医学杂志》2018年第22期68-73,共6页China Journal of Modern Medicine

基　　金：四川省科技厅重点研发项目(No:2017SZ0069)

摘　　要：目的回顾性分析不同优势肿瘤细胞分组的混合型肝癌(CHCC)的临床资料,探讨其临床特征和预后情况。方法收集CHCC病例的临床资料,按其瘤体内优势细胞类型分为3组:A组(HCC优势组18例)、B组(ICC优势组13例)、C组(混合组7例),比较各组病例的临床特征及预后情况。结果 3组患者年龄、性别、乙肝或丙肝感染例数、肿瘤数目和直径、肝硬化、Child-Pugh分级等一般临床资料差异无统计学意义(P>0.05)。手术类型、脉管癌栓、门静脉/胆管受侵、卫星灶、淋巴结转移,以及术后免疫组织化学染色情况和AJCC分期等术中、术后资料差异无统计学意义(P>0.05)。术前A组AFP值高于B组和C组(P<0.0125)。术后1年各组无瘤生存率分别为42.1%、62.7%和45.7%,差异无统计学意义(P>0.05);1年总体生存率分别为69.3%、76.2%和68.6%,差异无统计学意义(P>0.05)。结论无论瘤体内优势肿瘤细胞比例有无差异,CHCC临床特征基本无差异,都是一种预后较差的恶性肿瘤,现阶段的首选治疗方法是大部分肝切除。Objective To retrospectively analyze the clinical data of combined hepatocellular cholangiocarcinoma(CHCC)with different dominant tumor cells,and to explore the clinical characteristics and prognosis of CHCC.Methods The clinical data of 38 patients with CHCC were divided into 3 groups according to their dominant cell types:a group A(HCC dominant group,18 cases),a group B(ICC dominant group,13 cases),and a group C(mixed group,7 cases).The clinical features and prognosis of each group of patients were studied and compared.Results There were no significant differences in age,sex,hepatitis B or hepatitis C infection,tumor number or diameter,cirrhosis or Child-Pugh classification among the 3 groups(P>0.05).There were no statistically significant differences in postoperative data such as surgical type,microscopic vessel invasion,portal vein/bile duct invasion,number of satellite nodules,lymph node metastasis,postoperative immunohistochemical staining or AJCC staging among the 3 groups(P>0.05).AFP value in the group A was significantly higher than that in the group B and the group C(P<0.05).There were no significant differences in the 1-year tumor-free survival rates(42.1%,62.7%and 45.7%respectively,P>0.05)or the 1-year overall survival rates(69.3%,76.2%and 68.6%respectively,P>0.05).Conclusions Whether or not there is a difference in the proportion of dominant tumor cells in the tumor,CHCC is a malignant primary liver cancer with similar clinical characteristics and poor prognosis.Major hepatectomy is the most preferred method of treatment at the present stage.

关 键 词：混合型肝癌 优势肿瘤细胞 治疗 预后 

分 类 号：R735.7[医药卫生—肿瘤]