【摘要】 目的探讨肝内胆管细胞癌的临床外科特点及影响手术预后的因素。方法回顾性分析本院2010年1月～2015年5月收治的68例肝内胆管细胞癌患者的临床资料,采用Kaplan-Meier法计算生存率,Log-rank法比较各组间的生存差异,Cox回归分析进行多因素分析。结果本组60例手术切除患者,1年及3年生存率分别为65.40%和17.70%,根治性手术切除组和姑息性手术切除组的中位生存时间分别为20.7个月及14.2个月(P<0.05)。单因素分析显示,手术方式、淋巴结转移情况、乙肝表面抗原阳性、神经侵犯、肿瘤数目和术前CA19-9水平对预后有影响(P<0.05),多因素分析显示,手术方式、淋巴结转移情况、肿瘤数目和术前CA19-9水平为影响ICC预后的独立危险因素。结论肝内胆管细胞癌患者治疗以手术为主,根治性手术切除是获得长期生存的唯一途径。根治性切除、淋巴结转移情况、肿瘤数目及术前血清CA19-9水平是影响患者预后的独立危险因素。更多还原

【Abstract】 Objective To investigate the clinical surgical characteristics of intrahepatic cholangiocarcinoma and the factors affecting the prognosis of surgery. Methods The clinical data of 68 patients with intrahepatic cholangiocarcinoma admitted our hospital from January 2010 to May 2015 were retrospectively analyzed. Kaplan-Meier method was used to calculate survival rate, and log-rank method was used to compare survival between groups. Cox regression analysis was used for multivariate analysis. Results The 1-year and 3-year survival rates of the 60 patients who underwent surgical resection were 65.40% and 17.70%, respectively. The median survival time of the radical surgery resection group and the palliative surgical resection group were 20.7 months and 14.2 months, respectively(P<0.05). Univariate analysis showed that surgical methods, lymph node metastasis, hepatitis B surface antigen positive, neurological invasion, tumor number and preoperative CA19-9 level had an impact on prognosis(P<0.05). Multivariate analysis showed that surgical methods, lymph node metastasis, the number of tumors and preoperative CA19-9 levels were independent risk factors for the prognosis of ICC. Conclusion The treatment of patients with intrahepatic cholangiocarcinoma is mainly surgery. Radical surgical resection is the only way to obtain long-term survival. Radical resection, lymph node metastasis, tumor number, and preoperative serum CA19-9 levels are independent risk factors for prognosis.更多还原