Curative effect and prognostic impact of radical resection assisted by transcatheter arterial chemoembolization in treatment of intrahepatic cholangiocarcinoma
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摘要:
目的探讨根治性切除术辅助肝动脉化疗栓塞术(TACE)治疗肝内胆管细胞癌(ICC)的效果和预后。方法回顾性分析2008年1月-2010年12月武汉科技大学附属天佑医院肝胆外科收治的80例ICC患者临床资料,其中对照组35例患者接受根治术治疗,观察组45例患者接受根治性切除术后辅助TACE治疗,比较两组患者治疗效果与生存时间。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果观察组患者术后6个月血清糖类抗原(CA)19-9、甲胎蛋白(AFP)、癌胚抗原(CEA)、ALT含量分别为(47.35±13.76)μg/L、(309.5±125.55)μg/L、(20.86±10.38)ng/ml、(25.44±8.19)U/L,低于对照组的(83.54±24.17)μg/L、(375.85±136.77)μg/L、(34.18±8.55)ng/ml、(58.56±22.58)U/L,差异均有统计学意义(t值分别为19.58、101.33、29.46、32.25,P值均<0.05);观察组1、2、3年生存率高于对照组,差异有统计学意义(χ2值分别为11.43、20.15、9.87,...
Abstract:Objective To investigate the curative effect and prognostic impact of radical resection assisted by transcatheter arterial chemoembolization( TACE) in the treatment of intrahepatic cholangiocarcinoma( ICC). Methods The clinical data of 80 patients with ICC who were admitted to the Department of Hepatobiliary Surgery in our hospital from January 2008 to December 2010 were retrospectively analyzed.Thirty- five patients in the control group received radical resection,while forty- five patients in the observation group received adjuvant TACE therapy following radical resection. The curative effect and survival time were compared between the two groups. Comparison of continuous data between the two groups was made by t test,and comparison of categorical data was made by chi- square test. Results The observation group had significantly lower serum levels of alpha- fetoprotein,carcinoembryonic antigen,carbohydrate antigen 19- 9,and alanine aminotransferase than the observation group at 6 months after surgery( 47. 35 ± 13. 76 vs 83. 54 ± 24. 17 μg / L,t = 19. 58,P < 0. 05;309. 50 ± 125. 55 vs 375. 85 ± 136. 77 μg / L,t = 101. 33,P < 0. 05; 20. 86 ± 10. 38 vs 34. 18 ± 8. 55 ng / ml,t = 29. 46,P < 0. 05; 25. 44 ±8. 19 vs 58. 56 ± 22. 58 U / L,t = 32. 25,P < 0. 05). The 1- year,2- year,and 3- year survival rates in the observation group were significantly higher than those in the control group( χ2= 11. 43,P < 0. 05; χ2= 20. 15,P < 0. 05; χ2= 9. 87,P < 0. 05). The mean survival period was significantly longer in the observation group than in the control group( t = 15. 38,P < 0. 05). According to the analysis of factors influencing the survival period in patients with ICC,patients with a tumor size larger than 5. 0 cm,a low degree of differentiation,and metastasis had a significantly lower long- term survival rate and a significantly shorter mean survival period than other patients( P < 0. 05).Conclusion The adjuvant TACE therapy after radical resection is a safe and effective method in the treatment of ICC. The tumor size,degree of differentiation,portal vein tumor thrombus,and metastasis have a strong prognostic impact.
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Key words:
- intrahepatic cholangiocarcinoma /
- hepatectomy /
- chemoembolization,therapeutic /
- prognosis
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