摘要
目的 研究肝切除术治疗肝内胆管细胞癌(ICC)的疗效及影响因素。方法 采用回顾性分析研究方法,收集我院2015 年4月至2017年4月87例肝内胆管细胞癌患者临床病理资料,所有患者均行肝切除术治疗,分析临床疗效并对影响疗 效的因素进行分析。结果 87例患者1、3、5年的复发率分别为42.53%、66.67%、74.71%;1、3、5年的生存率分别 为65.52%、40.23%、26.44%;肿瘤直径>5cm、肿瘤多发、发生淋巴结转移、邻近器官侵犯、手术边缘阳性、术前 血清黏蛋白CA19-9>35U/ml、血清癌胚抗原(CEA)≤5μg/L、血清甲胎蛋白(AFP)≤25μg/L的肝内胆管细胞癌患者 行肝切除术后预后更差(P<0.05)。结论 肝切除术是治疗肝内胆管细胞癌的首选方式,肿瘤直径、肿瘤数目、淋巴 结转移、邻近器官侵犯、手术边缘以及CA19-9、CEA、AFP水平是影响ICC患者行肝切除术后的危险因素。
Objective To study the curative effect and influencing factors of hepatectomy in the treatment of intrahepatic cholangiocarcinoma (ICC). Methods The clinicopathological data of 87 patients with intrahepatic cholangiocarcinoma treated in our hospital from April 2015 to April 2017 were retrospectively analyzed. All the patients were treated with hepatectomy, and the clinical effects and influencing factors were analyzed. Results Among these 87 patients, the recurrence rates of 1, 3 and 5 years were 42.53%, 66.67% and 74.71%, and the survival rate of 1,3 and 5 years were 65.52%, 40.23% and 26.44%. ICC patients with symptoms as tumor diameter>5cm, multiple tumors, lymph node metastasis, invasion of neighboring organs, positive surgical margins, preoperative seromucoid CA19-9>35U/ml, serum carcinoembryonic antigen (CEA)≤5μg/L, serum alpha fetoprotein (AFP) ≤25μg/L had worse prognoses (P<0.05). Conclusion Hepatectomy is the first choice for the treatment of intrahepatic cholangiocarcinoma, and its influencing factors are tumor diameter, tumor numbers, lymph node metastasis, invasion of neighboring organs, surgical margin, and levels of CA19-9, CEA9 and AFP.
【关键词】肝切除术;肝内胆管细胞癌;疗效;影响因素
【中图分类号】R735.7;R657.3
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2019.01.025
前言
肝内胆管细胞癌(ICC)指的是起源于二级胆管及 其分支上的腺癌,其发病率呈逐年上升趋势,是仅次 于肝细胞癌的肝脏常见恶性肿瘤。ICC的临床特点是 侵袭性强,但早期无明显症状,很多患者确诊时已 错过手术时机,患者预后差[1]。肝切除术是目前治疗 ICC的最有效手段,但由于ICC本身显著的恶性生物 学特征导致肿瘤的复发率及转移率高,手术的长期疗 效不理想,患者的5年生存率仅有17%~30%[2]。因此 寻找影响ICC术后远期疗效的因素具有非常重要的现 实意义。本次研究特选取我院肝内胆管细胞癌患者87 例,分析其肝切除术后疗效及影响手术疗效的因素, 现将结果报告如下。
罕少疾病杂志
第26卷, 第 1 期
2019年01月
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