中国实用外科杂志

中国实用外科杂志

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肝内胆管细胞癌预后及其影响因素分析

王庆亮，叶小鸣，胡昆鹏，黄品助，刘    波   

  1. 中山大学附属第三医院 岭南医院普通外科，广东广州 510530
  • 出版日期:2014-08-01 发布日期:2014-07-23

  • Online:2014-08-01 Published:2014-07-23

摘要：

目的    探讨肝内胆管细胞癌（ICC）的预后及其影响因素。 方法    回顾性分析2002年8月至2012年12月中山大学附属第三医院收治的77例ICC病人的临床资料，采用Kaplan-Meier法绘制生存曲线和计算累积存活率，Log-rank检验及Cox回归模型评估影响预后的因素。 结果    77例病人1、3、5年存活率分别为44.4%、27.6%、23.6%，中位生存期为10个月。45例行根治性R0手术病人的1年、3年、5年存活率分别为69.4%、50.0%和42.5%，中位生存期为25个月。单因素分析表明，乙肝、肿瘤数目、血管侵犯、远处转移、TNM分期、手术方式和病理分化程度与预后密切相关（P＜0.05），多因素分析显示手术方式（χ2=36.091，P＜0.001）和肿瘤数目（χ2=9.496，P=0.002）是影响预后的独立因素。结论    手术方式和肿瘤数目是影响ICC病人预后的独立危险因素；根治性R0切除能明显改善预后，提高肝内胆管细胞癌病人存活率。

关键词: 肝内胆管细胞癌, 生存分析, 预后因素, 根治性切除

Abstract:

Prognostic factors and survival analysis of intrahepatic cholangiocarcinoma        WANG Qing-liang，YE Xiao-ming，HU Kun-peng，et al. Department of General Surgery，Ling Nan Hospital，the Third Affiliated Hospital of Sun Yat-sen University，Guangzhou 510530，China
Corresponding author：LIU Bo，E-mail: jakeliubo@gmail.com
Abstract    Objective    To investigate the prognostic factors and analyze the survival rates of intrahepatic cholangiocarcinoma（ICC） after surgery. Methods    The clinical data of 77 ICC patients admitted from August 2002 to December 2012 the Third Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. The cumulative survival rates were calculated and the survival curves were drawn using the Kaplan-Meier method. The prognostic factors were evaluated by Log-rank test and Cox proportional hazards regression model. Results    The 1-，3-，and 5-year overall cumulative survival rates of the 77 patients were 44.4%，27.6%，23.6% respectively and the median survival time was 10 months. The 1-，3-，and 5-year overall survival rates of the 45 patients performed radical R0 surgery were 69.4%，50.0% and 42.5% respectively and the median survival time was 25 months. According to the univariate analysis, hepatitis B，tumor numbers，vascular invasion，metastasis，TNM stages，operative modality and the degree of pathological differentiation were closely correlated with prognosis （P＜0.05）. Multivariate analysis indicated that operative modality （χ2=36.091，P＜0.001） and tumor numbers （χ2=9.496，P=0.002） were two independent prognostic factors. Conclusion    Operative modality and tumor numbers are independent prognostic factors of patients with ICC. Radical R0 resection can improve the survival rate of patients with ICC significantly.

Key words: intrahepatic cholangiocarcinoma, survival analysis, prognostic factors, radical resection