根治性手术切除治疗早期胆管细胞癌的预后影响因素分析

黄健; 蒋贝格; 杨远; 顾方明; 袁声贤; 潘泽亚

doi:10.3969/j.issn.1001-5256.2018.10.019

根治性手术切除治疗早期胆管细胞癌的预后影响因素分析

DOI: 10.3969/j.issn.1001-5256.2018.10.019

第二军医大学第三附属医院肝外三科

基金项目:

国家自然科学基金面上项目(81672721)；

详细信息

中图分类号: R735.8
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出版历程
- 出版日期: 2018-10-20

Influencing factors for the prognosis of patients with early-stage intrahepatic cholangiocarcinoma after radical resection

Third Department of Hepatic Surgery, The Third Affiliated Hospital of Second Military Medical University

Research funding:

摘要

摘要: 目的分析手术治疗早期胆管细胞癌（ICC）患者预后的相关因素。方法收集2013年1月-2014年12月于第二军医大学第三附属医院行根治性手术切除治疗的早期ICC患者共155例,分析其临床病理特点及术后1、2、3年总体生存率及无瘤生存率。采用Cox向前逐步回归单因素及多因素分析影响早期ICC预后相关因素。结果早期ICC多数为中年男性患者,平均直径为（5. 8±2. 5） cm,肝功能多无异常,伴有不同程度CA19-9水平升高,术后病理多为高中分化腺癌。患者术后1、2、3年的总体生存率分别为76. 1%、43. 9%和34. 1%,无瘤生存率分别为50. 3%、25. 0%和18. 1%。Cox多因素分析表明术前高水平CA19-9[风险比（HR）=1. 705,95%可信区间（95%CI）:1. 0962. 652,P=0. 018]、肝硬化（HR=2. 399,95%CI:1. 1085. 196,P=0. 026）、镜下子灶（HR=1. 918,95%CI:1. 1243. 272,P=0. 017）、肿瘤细胞分化程度（H...
- 肝肿瘤 /
- 肝切除术 /
- 危险因素 /
- 预后
Abstract: Objective To investigate the influencing factors for the prognosis of patients with early-stage intrahepatic cholangiocarcinoma ( ICC) after surgical treatment. Methods A total of 155 patients with early-stage ICC who underwent radical resection in The Third Affiliated Hospital of Second Military Medical University from January 2013 to December 2014 were enrolled in this study. Clinicopathological features and 1-, 2-, and 3-year overall survival rates and disease-free survival rates after surgery were analyzed. The Cox forward stepwise regression was used for the univariate and multivariate analyses of the influencing factors for the prognosis of early-stage ICC. Results Most patients with early-stage ICC were middle-aged men, with an average tumor diameter of 5. 8 ± 2. 5 cm. Most patients had normal liver function, but there were varying degrees of increase in carbohydrate antigen 19-9 ( CA19-9) level. Postoperative pathological examination revealed highly or moderately differentiated adenocarcinoma in most patients. The 1-, 2-, and 3-year overall survival rates after surgery were 76. 1%, 43. 9%, and 34. 1%, respectively, and the 1-, 2-, and 3-year disease-free survival rates were 50. 3%, 25. 0%, and 18. 1%, respectively. The Cox multivariate analysis showed that high CA19-9 level before surgery ( hazard ratio [HR]=1. 705, 95% confidence interval [CI]: 1. 096-2. 652, P = 0. 018) , liver cirrhosis ( HR = 2. 399, 95% CI: 1. 108-5. 196, P = 0. 026) , satellite nodules ( HR = 1. 918, 95% CI: 1. 124-3. 272, P = 0. 017) , and degree of tumor cell differentiation ( HR = 5. 568, 95% CI:2. 591-11. 965, P < 0. 0001) were independent risk factors for overall survival of patients early-stage ICC. Liver cirrhosis ( HR = 2. 142, 95% CI: 1. 054-4. 353, P = 0. 035) , satellite nodules ( HR = 2. 045, 95% CI: 1. 250-3. 343, P = 0. 004) , and degree of tumor cell differentiation ( HR = 2. 748, 95% CI: 1. 340-5. 638, P = 0. 006) were independent risk factors for disease-free survival of patients early-stage ICC. Conclusion Radical resection is the preferred treatment for patients with early-stage ICC. Preoperative CA19-9 ≥200 U/ml, liver cirrhosis, satellite nodules, and degree of tumor cell differentiation are independent risk factors for the prognosis of early-stage ICC.
- liver neoplasms /
- hepatectomy /
- risk factors /
- prognosis

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