影响肝内胆管癌手术预后的危险因素Logistic回归分析

目的: 探讨肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)患者术后复发／转移的高危因素。方法: 回顾性分析128例ICC手术患者临床资料,根据术后3年内复发、转移情况分为预后不良组(n=60)与对照组(n=68)。单因素比较两组基线资料、手术处理、肿瘤病理、生化指标等差异,将比较结果差异有统计学意义的指标纳入非条件Logistic二元回归模型,筛选出术后复发、转移的独立危险因素。结果： 肿瘤直径≥5 cm、门静脉浸润阳性、淋巴结转移阳性、Bismuth Corlette肝门胆管癌分型级别较高及糖类抗原19 9(CA19 9)≥150 U／mL均是导致ICC患者术后预后不良的独立危险因素(P<0.05)。 结论： 诸如肿瘤直径、门静脉浸润、淋巴结转移、Bismuth Corlette分型等肿瘤病理情况及CA19 9均可独立影响ICC患者术后预后,临床预防肿瘤术后复发、转移需尽早识别并引起重视。

Logistic regression analysis of risk factors affecting prognosis of patients with intrahepatic cholangiocarcinoma surgery

Objective: To figure out the high risk factors for postoperative recurrence／metastasis in patients with intrahepatic cholangiocarcinoma(ICC). Methods: The clinical data of 128 patients with ICC were retrospectively analyzed. According to the recurrence／metastasis within 3 years after operation, the patients were divided into poor prognosis group(n=60) and control group(n=68). Univariate comparison was used to compare the baseline data, surgical treatment, tumor pathology and biochemical indicators in the two groups, and the indicators with statistical significance were included in the unconditional Logistic binary regression model to screen out the independent risk factors for postoperative recurrence and metastasis. Results: Tumor diameter≥5 cm, portal vein positive infiltration, positive lymph node metastasis, high Bismuth Corlette hilar cholangiocarcinoma classification and carbohydrate antigen 19 9 (CA19 9)≥150 U／mL were the independent risk factors for postoperative poor prognosis of patients with ICC(P<0.05). Conclusion: Tumor pathology conditions of tumor diameter, portal vein infiltration, lymph node metastasis and Bismuth Corlette classification and serum tumor marker of CA19 9 can independently have a profound impact on the prognosis of patients with ICC surgery.