八所医院胆管癌680例分析

An analysis of 680 cases of cholangiocarcinoma in 8 hospitals

目的为了解我国胆管癌病人诊断、治疗的现况。方法回顾性分析8所医院的680例胆管癌临床调查资料(1995～2001年),采用SSPS软件进行统计分析。结果(1)60～65岁年龄组胆管癌的人数最多,男性多于女性,男女比为139∶1;(2)上段胆管癌多见,占416%,其次为下段癌,占287%;(3)B超是胆管癌影像学诊断的首选检查占803%,无创性检查如CT、MRCP应用率高于有创性检查如PTC、ERCP;(4)上段胆管癌中高分化癌仅占49.3%,低中分化癌占一半以上;(5)胆管癌多为晚期,手术切除率低,手术切除仅为216%(147/680)。结论胆管癌目前是一种老年男性病人常见的恶性消化道肿瘤,与10年前相比胆管癌的诊断和治疗虽有提高但仍未取得突破性进展,就诊病人多处于晚期,手术切除率低。因此,要从根本上改变胆管癌的疗效,必须加强其早期诊断和治疗。

Objective To investigate the status quo of diagnosis and treatment of cholangiocarcinoma in our country. Methods The clinical data of 680 patients with cholangiocarcinoma treated in 8 hospitals from 1995 to 2001 were retrospectively analyzed with SSPS software package. Results 1) The incidence of the tumor was the highest in the age group of 60-65. Meanwhile, the incidence was higher in aged males than in aged females and the sex ratio (male : female) was 1.36∶1. 2) The most common type was proximal cholangiocarcinoma (41.6%) and distant cholangiocarcinoma was the second common (28.7%). 3) B-mode ultrasonography was the chief image examination for the tumor (80.3%). The application rate of non-traumatic examinations such as CT and MRCP etc. was higher than that of traumatic examinations such as PTC and ERCP etc. 4) The low-and moderately-differentiated tumor of the proximal bile duct accounted for about 50%. 5) Most of the patients suffered from late-stage cholangiocarcinoma. The resection rate was low and the rate of radical operation was only 21.6% (147/680). Conclusions Cholangiocarcinoma is common in the aged males. Its diagnosis and treatment have been improved, but there is no abrupt advance. Most of the patients suffer from late-stage cholangiocarcinoma and the rate of radical operation is low. Therefore, we should reinforce the early diagnosis and treatment of cholangiocarcinoma to improve outcome after operation.