肝内胆管结石合并肝内胆管癌的诊断分析

DIAGNOSIS AND ANALYSIS OF HEPATOLITHIASIS WITH CHOLANGIOCARCINOMA

目的 分析肝内胆管结石合并肝内胆管癌的相关因素 ,提高术前诊断率。方法 1997年 1月至 2 0 0 3年 9月本院肝内胆管结石合并肝内胆管癌资料较齐全病人 13例 ,与同期肝内胆管结石手术病人 2 0例进行回顾性比较分析 ,采用单因素及多因素分析的方法 ,研究肝内胆管结石合并肝内胆管癌的相关因素。结果 单因素分析显示年龄、病程、6月内胆管炎发作次数、血 CEA、血 CA1 9- 9、肝内占位与肝内胆管结石合并肝内胆管癌有关 ,进一步通过多元逐步回归分析发现肝内占位为肝内胆管结石合并肝内胆管癌的独立因素。结论 对年龄高、病程长、近期内反复发作病人进行血 CEA、血 CA1 9- 9、CT、MRI等检查 ,有利于提高肝内胆管结石合并肝内胆管癌的术前诊断率。

Objective To investigate the contributing factors of hepatolithiasis with cholangiocarcinoma in order to improve the preoperation diagnosis.Methods The clinical materials of 13 cases of the hepatolithiases with cholangiocarcinoma was analyzed,and compared with 20 cases of hepatolithiases in the same period retrospectively.Univariate and muitvariate analysis were applied to study the contributing factors of hepatolithiasis with cholangiocarcinoma.Result Univariate analysis showed that the age,history of hepatolithisasis,the times of cholangitis breaking out in 6 mouths,CEA,CA 19-9 ,occupied lesion in liver were associated with hepatolithiasis with cholangiocarcinoma.Furthermore,multiple stepwise regression analysis indicated that occupied lesion in liver was an independent contributing factor.Conclusion The advanced age patients with long-term hepatolithiasis and recurrent cholangitis were determined by CEA and CA 19-9 ,and were examined by B-mode ultrosonography and computer tomography and magnetic resonance imaging,which help to find hepatolithiasis with cholangiocarcinoma in preoperation.