乙肝相关混合型肝细胞癌-胆管癌切除术后早期复发的影响因素

目的 探讨乙肝相关混合型肝细胞癌-胆管癌（combined hepatocellular-cholangiocarcinoma,c HCC-CCA）患者手术切除后早期复发的影响因素。方法 收集2016年1月至2020年12月在解放军总医院第五医学中心行根治性切除并经病理证实的乙肝相关c HCC-CCA患者40例。收集临床病理及随访资料。采用Kaplan-Meier分析无复发生存（recurrence-free survial,RFS）情况。采用单因素和多因素分析确定独立预后因素。结果 患者术后1年、1.5年、2年累积无复发生存率分别为37.5%、15.0%和2.5%，无复发生存中位时间为11.4个月。单因素及多因素分析显示，微血管癌栓分型M2(HR 4.196,95%CI 1.147～15.357,P=0.030)、非解剖性肝切除（HR 2.551,95%CI 1.051～6.193,P=0.039）、术前乙肝病毒载量> 100 IU/m L(HR 3.391,95%CI 1.090～10.557,P=0.035)，是影响乙肝相关c HCC-CCA患者术后复发的独立因素。结论 微...

Influencing factors of early recurrence after curative resection of hepatitis B-related combined hepatocellular-cholangiocarcinoma

Objective To investigate the influencing factors of early recurrence after curative resection in patients with hepatitis B-related combined hepatocellular-cholangiocarcinoma (cHCC-CCA). Methods A total of 40 pathologically confirmed hepatitis B-related cHCC-CCA patients undergoing curative resection between Jan. 2016 and Dec. 2020 at the Fifth Medical Center of PLA General Hospital were included. The clinicopathological and follow-up data were retrieved. Recurrence-free survival (RFS) rate and time were analysed by Kaplan-Meier curve. The independent prognostic factors were determined with univariate and multivariate analyses. Results The pstoperative 1-, 1.5-, and 2-year cumulative RFS rate in cHCC-CCA patients were 37.5%, 15.0% and 2.5%, respectively, the median RFS was 11.4 months. Univariate and multivariate analyses showed that microvascular carcinoma embolism staging M2 (HR 4.196, 95%CI 1.147-15.357, P=0.030), non-anatomic liver resection (HR 2.551, 95%CI 1.051-6.193, P=0.039), preoperative hepatitis B viral load >100 IU/mL (HR 3.391, 95%CI 1.090-10.557, P=0.035), were independent factors affecting early recurrence after curative resection in hepatitis B-related cHCC-CCA patients. Conclusion Microvascular carcinoma embolism staging M2, non-anatomical liver resection, and preoperative viral load >100 IU/mL were independent prognostic factors for hepatitis B-related cHCC-CCA.