肝门胆管癌预后的影响因素分析

Analysis on the influencing factor for the prognosis of hilar cholangiocarcinoma

目的分析影响肝门胆管癌预后的因素。方法回顾分析我院自1999年10月至2008年5月期间71例肝门胆管癌病例资料。结果多因素生存回归分析提示,血清CEA水平(x2=14.56,P=0.004)、手术方式(x2=22.49,P<0.001)、TNM分期(x2=12.31,P=0.005)与肝门胆管癌预后显著相关。血清CEA升高者和正常者平均生存时间分别为(7.1±5.6)个月和(10.6±7.4)个月,存在统计学差异(P<0.05);根治性切除、姑息性切除、单纯引流及未经治疗者平均生存时间分别为(17.1±9.6)个月、(1 0.6±4.2)个月、(7.4±2.5)个月、(3.4±1.4)个月,存在统计学差异(P<0.0 5);I期、II期、II I期、IV a期、IV b期平均生存时间分别为(1 8.5±5.9)个月、(1 6.7±1 0.0)个月、(1 3.2±8.7)个月、(1 0.9±7.4)个月、(8.3±6.3)个月,存在统计学差异(P<0.05)。结论术前血清CEA正常、根治性手术切除、分期较早的患者肝门胆管癌预后相对较好。

Objective To analyze the prognostic factors of hilar cholangiocarcinoma.Methods Retrospective analysis was carried out for 71 cases of hilar cholangiocarcinoma admitted in our hospital from October 1999 to May 2008.Prognostic factors were analyzed.Results Multi-factor regression analysis revealed that 3 variables were significantly relative to the survival time of hilar cholangiocarcinoma,including serum CEA levels（x2=14.56,P =0.004）,surgical procedure（x2=22.49,P 0.001） and TNM stage（x2=12.31,P =0.005）.The average survival times of serum CEA positive and negative were（7.1 ± 5.6） months and（17.2 ± 9.2） months,and there was significant difference（P 0.05）.The average survival times of hilar cholangiocarcinoma with radical resection,palliative resection,simple drainage and without treatment were（17.1 ± 9.6） months,（10.6 ± 4.2） months,（7.4 ± 2.5） months and（3.4 ± 1.4） months,and there was significant statistic difference（P 0.05）.The average survival times of Stage I,Stage II,Stage III,Stage IVa and Stage IVb were（18.5 ± 5.9） months,（16.7 ± 10.0）months,（13.2 ± 8.7） months,（10.9 ± 7.4） months,and（8.3 ± 6.3） months,and there was significant difference（P 0.05）.Conclusion The prognosis of hilar cholangiocarcinoma patient with normal serum CEA,radical resection and Stage I are much better.