26例混合型肝癌临床特点及预后分析  

Clinical characteristics and prognosis of 26 cases of combined hepatocellular carcinoma and cholangiocarcinoma

作　　者：吴林鸿 高鹏骥[2] 高杰[2] 李照[2] 朱继业[2] 冷希圣[2] Wu Linhong;Gao Pengji;Gao Jie;Li Zhao;Zhu Jiye;Leng Xisheng(Department of Hepatobiliary Surgery,Hospital of Traditional Chinese Medicine,Qiannan Buyi and Miao Autonomous Prefecture,Guizhou Province,Duyun 558000,China;Department of Hepatobiliary Surgery,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]贵州省黔南州中医医院肝胆外科,都匀558000 [2]北京大学人民医院肝胆外科,100044

出　　处：《中华普通外科杂志》2020年第2期128-130,共3页Chinese Journal of General Surgery

摘　　要：目的探讨混合型肝癌(combined hepatocellular carcinoma and cholangiocarcinoma,cHCC-CC)的临床表现、影像学特点及预后情况。方法回顾性分析26例行肝脏切除手术病理诊断为cHCC-CC的临床病例资料,对影响其预后的相关因素进行统计学分析。结果26例cHCC-CC患者中,慢性病毒性肝炎19例,其中慢性乙型病毒性肝炎17例、慢性丙型病毒性肝炎2例。甲胎蛋白(alpha fetoprotein,AFP)≥20 ng/ml 18例,糖类抗原199(glycoantigens 199,CA199)≥37 U/ml 9例,癌胚抗原(carcinoembryonic antigen,CEA)≥5 ng/ml 5例。患者肝脏切除术后1、3、5年的生存率为68.8%、34.4%、17.4%。多因素分析显示血清CA199≥37 U/ml(χ2=5.687,P=0.019)是影响患者生存的独立危险因素。结论cHCC-CC多见于慢性病毒性肝炎患者或病毒携带者,血清CA199≥37U/ml是影响患者生存的独立危险因素。Objective To investigate the clinical manifestations,imaging features and prognosis of mixed liver cancer.Methods The clinical and pathological data of 26 patients with combined hepatocellular carcinoma and cholangiocarcinoma(cHCC-CC)pathologically diagnosed after liver resection were retrospectively analyzed,and the relevant factors affecting the prognosis were statistically analyzed.Results Of the 26 cHCC-CC patients,19 were on background of chronic viral hepatitis,including 17 chronic viral hepatitis B and 2 chronic viral hepatitis C.There were 18 cases having AFP≥20ng/ml,9 cases were with carbohydrate antigen 199(CA199)≥37U/ml,and 5 cases with carcinoembryonic antigen(CEA)≥5ng/ml.The 1-,3-,and 5-year postoperative survival rates were 68.8%,34.4%,and 17.4%.Multivariate analysis showed that serum CA199≥37U/ml(χ2=5.687,P=0.019)was an independent risk factor for patients′survival.Conclusion Most cHCC-CC is found in association with chronic viral hepatitis.Serum CA199≥37U/ml is an independent risk factor affecting patients survival.

关 键 词：癌 肝细胞 预后 存活率分析 

分 类 号：R735[医药卫生—肿瘤]