【摘要】 目的探讨肝细胞-胆管细胞混合型肝癌(combined hepatocellular-cholangiocarcinoma,cHCC-CC)的临床特点、术后生存状况及影响因素。方法回顾性分析2005-01-01-2013-12-31枣庄市立医院行手术切除的30例cHCC-CC患者临床资料,描述临床特点,并分析生存状况。结果 30例患者均经病理确诊为cHCC-CC。平均年龄(57.7±10.2)岁,中位年龄52岁。肿瘤大小为2~13cm,中位数为7cm。完整随访28例,有效随访率为93.3%。根据Kaplan-Meier生存分析,中位生存时间为18个月,中位无复发生存时间为15个月。1、3和5年生存率分别为67.8%、33.4%和24.3%,1、3和5年无复发生存率分别为58.5%、23.3%和12.1%。Cox分析结果显示,有临床症状(HR=5.1,P=0.008)、切缘阳性(HR=4.0,P=0.001)、淋巴结转移(HR=6.0,P=0.009)和脉管瘤栓(HR=2.9,P=0.019)是病死率的主要影响因素;有临床症状(HR=5.1,P=0.009)、切缘阳性(HR=6.9,P=0.006)、淋巴结转移(HR=6.6,P=0.004)和脉管瘤栓(HR=3.0,P=0.003)是复发率的主要影响因素。术后介入治疗是患者病死率(HR=0.4,P=0.015)和复发率(HR=0.5,P=0.008)的保护因素。结论 cHCC-CC预后不佳,影响cHCC-CC患者术后生存因素主要是临床症状、切缘阳性、淋巴结转移、脉管瘤栓和辅助介入治疗。更多还原

【Abstract】 OBJECTIVE To explore the clinicalpathological features,survival and impact factors of hepatocellular carcinoma and cholangiocarcinoma(HCC-CC).METHODS Thirty patients received surgery were diagnosed with combined HCC-CC in Zaozhuang City Hospital during 1st Jun.2005 and 31st Dec.2013.The clinical records and clinicopathological data were retrospectively analyzed.RESULTS All of the 30 patients were HCC-CC,whose mean age was 57.7±10.2,and median age was 52.The median diameter of the tumors was 7cm(2-13cm).Twenty-eight patients had completed follow-up,and the rate of follow-up was 93.3%.The median overall survival time was 18 months,while the median progression free survival time was 15 months by Kaplan-Meier analysis.The 1-,3-and 5-year survival rates were 67.8%,33.4% and 24.3%respectively.1-,3-and 5-year relapse-free survival rates were 58.5%,23.3%and 12.1%.Cox analysis indicated that clinical symptoms(HR=5.1,P=0.008),positive surgical margin(HR=4.0,P=0.001),lymph node metastasis(HR=6.0,P=0.009)and tumor embolus(HR=2.9,P=0.019)were risk factors for mortality;Also,clinical symptoms(HR=5.1,P=0.009),positive surgical margin(HR=6.9,P=0.006),lymph node metastasis(HR=6.6,P=0.004)and tumor embolus(HR=3.0,P=0.003)were risk factors for recurrence.Postoperative interventional therapy was protective factor of mortality(HR=0.4,P=0.015)and recurrence(HR=0.5,P=0.008).CONCLUSIONLymph node metastasis,tumor embolus and postoperative interventional therapy are infected factors for the survival rate of the HCC-CC.更多还原