【作者】 邓敏；

【导师】 仇毓东；

【作者基本信息】 南京大学 ， 临床医学（专业学位）， 2016， 硕士

【摘要】 目的:通过与传统型肝内胆管癌(conventional Intrahepatic Cholangiocarcinoma,cICC)的比较,探讨细胆管细胞癌(Cholangiolocellularcarcinoma,CLC)的临床、病理特点。方法:回顾分析2006年至2014年在南京大学医学院附属鼓楼医院肝胆胰外科手术切除的94例CLC、cICC病例资料。其中,CLC28例,cICC66例,通过术后病理对ICC及cCLC进行鉴别,从病史、血清学、病理、预后等方面分析和对比两种类型胆管癌的特点。结果:(1)在病史和血清学检查方面:与cICC比较,CLC常常合并肝硬化背景,术前可有血清AFP的升高,差异有统计学意义(P<0.05)。与CLC比较,cICC大多合并胆管结石或胆管炎病史,术前血清CA19-9较高,差异有统计学意义(P<0.05);(2)病理方面:与cICC比较,CLC有病灶数目较多等特点,差异有统计学意义(P<0.05);与CLC比较,cICC易发生神经侵犯,差异有统计学意义(P<0.05);虽然cICC淋巴结转移更常见,但差异未检出统计学意义(P>0.05);(3)预后方面:随访两类肿瘤的中位生存期及1、3年生存率。与cICC比较,CLC的中位生存期较长,1、3年生存率较高,但差异未检出无统计学意义(P>0.05)。与CLC比较,cICC的术后1年复发率较高,差异有统计学意义(P<0.05)。结论:CLC是一种较为特殊的来源于胆管细胞的肿瘤,其临床、病理及预后特点与传统型ICC有所不同,有必要深入探讨其内在的病理机制,制定更加具有针对性的诊疗策略。更多还原

【Abstract】 Objective:To investigate the clinical,pathological features of Cholangiolocellular carcinoma(CLC)and conventional intrahepatic cholangiocarcinoma(cICC),in addition to investigate the relationship between these features and prognosis.Methods:94 datum of CLC and cICC were retrospectively analyzed in Hepatopancreatobil iary Surgery Department of the Drum Tower Hospital from 2006 to 2014.These cases were pr eoperatively diagnosed and pathologically proved,among which 28 were CLC and 66 were cICC.cICC and CLCwere identified by postoperative pathology,and the features of them wer-e analysised through medical histories and pathological data.Results:(1)In medical history,cICC mostly exist with cholangitis or bile duct stones compared to CLC,and CA19-9 in serum is higher before operation,while the cirrho sis is more common in CLC,and AFP in serum is higher before operation(P<0.05).(2)In pathology,neural invasion occurs easily in cICC while a larger number of tumor lesions occur in CLC(P<0.05),while lymph node metastasis is easier to occur in cIC C,of which the difference was not statistically significant(P>0.05);(3)In follow-up d ata,cICC are easier to relapse in early period of postoperation,of which the differenc e was statistically significant(P<0.05);Although the difference of the median survival time and 1-year and 3-year survival rates was not statistically significant in these tw o kinds of tumors,median survival time of CLC is longer than that of cICC,and the 1-year and 3-year survival rate of CLC is higher than that of cICC.Conclusions:The clinical and pathological features and early recurrence of CLC and cICC are different,it is necessary to further explore the inner pathological mechanism in order to develop more targeted treatment strategies.更多还原