摘要
目的探讨影响肝门部胆管癌根治术患者预后的危险因素。方法回顾性分析2004年1月至2012年2月间陕西省榆林市二院收治的99例接受肝门部胆管癌根治术患者,根据病历记录及术后5年随访结果分为术后生存0~3年组（A组,68例）和术后生存3年以上组（B组,31例）。比较两组患者年龄、性别、病程、手术史、肿瘤直径等临床特征,比较患者的术前糖类抗原19-9（CA19-9）、Bismuth-Corlitte分型、肿瘤分化程度、淋巴结转移情况、门静脉浸润及尾状叶浸润情况;影响预后的多因素分析采用非条件Logistic回归分析。结果 B组患者的肿瘤直径显著小于A组,差异有统计学意义（P〈0.05）;两组患者在Bismuth-Corlitte分型方面差异无统计学意义（P〉0.05）。单因素分析显示,A组患者以术前CA19-9指标〉150 U/ml、肿瘤中低分化、淋巴结出现转移、门静脉及尾状叶浸润者居多,与B组患者比较,差异均有统计学意义（均P〈0.05）。多因素分析结果显示,肝门部胆管癌根治术后生存期长短与肿瘤直径及术前CA19-9指标呈负相关（均P〈0.05）,与肿瘤分化程度、淋巴结转移、门静脉浸润及尾状叶浸润呈正相关（均P〈0.05）。结论肿瘤直径、淋巴结转移、门静脉浸润、尾状叶浸润、肿瘤分化程度、术前CA19-9等均为影响肝门部胆管癌根治术患者预后的危险因素。
Objective To explore the influence factors of prognosis of patients with hepatic bile duct carcinoma radical portal vein. Methods From January 2004 to February 2012,99 patients who underwent hepatic bile duct carcinoma radical portal vein were enrolled in the study. According to their medical records and postoperative follow-up of 5 years,they were divided postoperative survival 0 ~ 3 years groups（ group A,n = 68） and postoperative survival more than 3 years group（ group B,n = 31）. The age,gender,course of the disease,surgery history,tumor diameter,such as general data differences were summed. Preoperative carbohydrate antigen 19-9（ CA19-9） indexes,Bismuth-Corlitte type,degree of tumor differentiation,lymph node metastasis,portal vein invasion and caudate lobe infiltration were recorded; Single factors were analyzed by Logistic regression analysis. Results The age,sex,course of the disease,surgery,and other general information between the two groups showed no significant differences（ P〉0. 05）. Tumor diameter of group A was significantly less than group B,with significant difference（ P〈0. 05）; Bismuth-Corlitte classification between the two groups showed no statistical significance（ P〉0. 05）; Compared with group B,preoperative CA19-9 index 150 U / ml,low tumor differentiation,lymph node metastasis of group A showed significant differences（ P〈0. 05）; The hepatic portal vein of the epigenetic term with bile duct carcinoma radical tumor diameter and preoperative CA19-9 index showed a negative correlation（ P〈0. 05）; With the degree of tumor differentiation,lymph node metastasis,portal vein invasion and caudate lobe infiltration was a positive correlation（ P〈0. 05）. Conclusions Tumor size,lymph node metastasis,portal vein invasion,caudate lobe infiltration,differentiation degree of tumor,preoperative CA19-9 are valuable factors with hepatic bile duct carcinoma radical portal vein in the quality of risk factors,which should be paid attention during clinical widely.
出处
《中国肿瘤临床与康复》
2015年第10期1184-1187,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
肝门部胆管癌
根治术
预后质量
危险因素
Hilar cholangiocarcinoma
Radical resection
Prognosis of quality
Risk factors
