肝内胆管细胞癌的外科治疗及预后分析.pdfVIP

Analysis of surgical treatment and prognosis of intrahepatic cholangiocarcinoma Abstract Objective: To analyze identify prognostic factors after surgical management of intrahepatic cholangiocarcinoma (ICC). Methods: Clinical and pathological data of 63 patients who underwent surgery management for ICC were analyzed，and were identified prognostic factors. Results: Median overall survival after surgical treatment of 63 ICCs was 19 months, 1-, 3-, and 5-year overall survival was54%, 25.4%, and 12.7%, respectively. 1, 3, 5 year survival rates of the radical resection were 64.4%, 35.6%, 17.7%; 1, 3, 5 year survival rates of the palliative resection were 40%, 0%, 0%; 1, 3, 5 year survival rates of the laparotomy were 23%, 0%, 0%.Univariate analyses showed that Ca199 increased, lymph node metastasis, distant metastasis, poor differentiation, JACC the higher the grade, the palliative operation or laparotomy were associated with poor prognosis.COX multivariate analysis showed that Ca199, the degree of tumor differentiation, operation mode is one of the factors affecting the prognosis of patients with the independent. Conclusions: The radical resection operation is the preferred treatment for ICC.Ca199 increased, the degree of tumor differentiation and operation mode of operation is independent indices in patients with the treatment and prognosis. Key words：Intrahepatic cholangiocarcinoma(ICC)；Surgical operation treatmentt； Prognosis analysis. 5 前言 肝内胆管细胞型肝癌（Intrahepatic cholangiocarcinoma，ICC）指发生在 包括二级胆管在内的末梢侧的原发性胆管细胞癌。由于 ICC 临床表现缺乏特异 性，所以早期确诊困难、误诊率高、就诊时病期较晚、根治性手术切除率低，预 后不佳。传统观点将 ICC 与肝细胞型肝癌及混合型肝癌都统归于原发性肝癌 (Primary 1iver carcinoma，PLC)。但随着对ICC 的深入认知，发现其流行病学、 临床表现、生物学行为、治疗及预后均有自己的特点。根治性手术切除是唯一能 治愈ICC 的手段，但