肝内胆管细胞癌预后因素分析

目的研究影响肝内胆管细胞癌（ICC）手术预后的因素，探讨提高ICC疗效的途径。方法回顾分析1996年12月至2003年6月在我院手术治疗的183例ICC病人的临床资料，对成功随访到的132例病人用Cox回归模型，选择15个对预后可能产生影响的因素进行统计学分析。结果132例外科手术治疗病人1，3，5年生存率分别为51．3％、21．6％和11．8％，统计分析结果显示病人的预后与手术方式、病理分型、是否淋巴结转移以及术前血清CA19—9水平显著相关，而与是否输血、放疗、化疗、肿瘤大小、肝硬化、AFP、TBIL、A／G（白球蛋白比）、性别、年龄等无明显相关。结论规则性肝叶切除＋淋巴结清扫手术是ICC主要的治疗措施；对于术后肝内复发和淋巴结转移的积极预防和治疗是提高ICC生存率的主要策略。

Prognostic analysis for intrahepatic cholangiocarcinoma

Objective To investigate the prognostic factors after surgical procedure for intrahe-patic cholangiocarcinoma (ICC). Methods The clinical data of 132 patients with ICC surgically treated in our hospital from December 1996 to July 2003 were retrospectively analyzed. Fifteen clinico-pathological factors that could possibly influence the survival of patients were selected A multivariate analysis of these 15 factors was performed using the Cox proportional hazards model. Results The 1-, 3- and 5-year survival rates of the 132 patients were 51. 3%, 21. 6% and 11. 8%, respectively. The statistical analysis showed that surgical procedure, lymph node metastasis, serum level of CA19-9 and pathological differentiation grade significantly affected postoperative survival However, the blood transfusion, postoperative radiotherapy and chemotherapy, tumor size, serum level of AFP, cirrhosis, preoperative total serum bilirubin level, and ratio of albumin to globulin (A/G), gender and age were not significant factors affecting the postoperative survival Conclusions Hepatectomy and lymph node dissection are major curative measures for ICC. Active treatment and prevention of postoperative intra-hepatic recurrence and lymph node metastasis is important for improvement of survival of the patients with ICC.