手术切除的肝门部胆管癌的临床特点及预后因素分析

doi:10.11904/j.issn.1002-3070.2015.03.003

实用肿瘤学杂志 ›› 2015, Vol. 29 ›› Issue (3): 203-207.doi: 10.11904/j.issn.1002-3070.2015.03.003

手术切除的肝门部胆管癌的临床特点及预后因素分析

刘钦兰^1,2, 闫晓杰², 夏学明², 白莉²

1.南开大学医学院(天津 300071)2.中国人民解放军总医院肿瘤内科

收稿日期:2014-11-04 出版日期:2015-06-28 发布日期:2015-06-25
通讯作者: 白莉 E-mail:baili0795@yahoo.com
作者简介:刘钦兰,女,(1988-),硕士研究生,从事肿瘤综合治疗的研究

Analysis of the clinical characteristics and its prognostic factors for hilar cholangiocarcinoma with exairesis

LIU Qinlan^1,2,YAN Xiaojie²,XIA Xueming²,BAI Li²

1.Medical School of Nankai University,Tianjin 300071,China;
2.Department of Oncology,Chinese PLA General Hospital

Received:2014-11-04 Online:2015-06-28 Published:2015-06-25

摘要/Abstract

摘要：

目的探讨经手术治疗的肝门部胆管癌患者的临床特点及与预后相关的因素。方法回顾性分析58例行手术治疗的肝门部胆管癌患者的临床资料,应用Kaplan-Meier法计算生存率,对可能影响患者预后的因素分别进行单因素分析(Log-rank检验),应用Cox比例风险模型进行多因素统计分析。结果 58例肝门部胆管癌患者的中位生存时间为22.00个月,1年、3年、5年生存率分别为76%、40%和21%。单因素分析表明术前血清白蛋白(P=0.002)、术中出血量(P=0.039)、手术方式(P=0.006)、分化程度(P=0.001)、是否侵及门静脉(P=0.014)、手术切缘有无癌细胞(P=0.020)对患者的术后生存时间有显著性影响。多因素分析结果显示手术方式(P=0.022)、肿瘤分化程度(P=0.020)是影响患者生存的独立预后因素。结论术前血清白蛋白低于35g/L、术中出血量大于＞500mL、肿瘤低分化、门静脉浸润、根治性切除(R₀)、手术切缘癌细胞阳性是影响肝门部胆管癌患者预后的危险因素。

关键词: 肝门部胆管癌, 生存分析, 预后因素

Abstract:

Objective To investigate the clinical characteristics and its prognostic factors for hilar cholangiocarcinoma with exairesis.Methods The clinical data of 58 cases of hilar cholangiocarcinoma were retrospectively analyzed.The Kaplan-Meier method was used to estimate the overall survival and disease specific survival rates for these patients.And the factors that may influence the prognosis and survival of patients were analyzed using univariate(log-rank test)and multivariate Cox proportional hazard models.Results The median survival time was 22 months for all patients.The 1-,3-and 5-year survival rates were 76%,40% and 21%,respectively.Univariate analysis showed that preoperative albumin(P=0.002),intraoperative blood loss(P=0.039),surgical method(P=0.006),histologic differentiation(P=0.001),portal vein encroached(P=0.014),surgical margin(P=0.020)were correlated factors for postoperative survival duration.Multivariate analysis by Cox Proportional Hazard Model showed that surgical method(P=0.022),histologic differentiation(P=0.020)were independent prognostic factors for patients with Hilar cholangiocarcinoma excised.Conclusion Low albumin leve,intraoperative blood loss more than 500mL,low degree of tumor differentiation,portal vein encroached,radical surgery,positive surgical margin are risk factors for total survival of Hilar cholangiocarcinoma.

Key words: Hilar cholangiocarcinoma, Survival data analysis, Prognosis factors

中图分类号:

R735.8

刘钦兰^1,2, 闫晓杰², 夏学明², 白莉². 手术切除的肝门部胆管癌的临床特点及预后因素分析[J]. 实用肿瘤学杂志, 2015, 29(3): 203-207.

LIU Qinlan,YAN Xiaojie,XIA Xueming,BAI Li. Analysis of the clinical characteristics and its prognostic factors for hilar cholangiocarcinoma with exairesis[J]. PRACTICAL ONCOLOGY JOURNAL, 2015, 29(3): 203-207.

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手术切除的肝门部胆管癌的临床特点及预后因素分析

Analysis of the clinical characteristics and its prognostic factors for hilar cholangiocarcinoma with exairesis

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