肝内胆管细胞癌危险因素及发病机制研究

Risk factors and pathogenesis of intrahepatic cholangiocarcinoma

目的探讨肝内胆管细胞癌(ICC)危险因素及发病机制。方法 102例ICC患者为病例组,200例无肿瘤体检者为对照组,对比两组ICC相关因素;并将病例组按血清HBsAg表达分组,对比两组临床病理学特征。结果病例组和对照组之间血清HBsAg阳性、HBV相关性肝硬化、酒精性肝硬化、其他原因肝硬化、肝内胆管结石、胆总管结石及肝吸虫病检出率之间有统计学意义(P<0.05)。HBV相关性肝硬化、酒精性肝硬化、肝内胆管结石、其他原因肝硬化、血清HBsAg阳性及肝吸虫病与ICC密切相关(P<0.05)。血清HBsAg阳性组和血清HBsAg阴性组年龄、性别比、AFP水平、CA19-9水平、肿瘤位置、组织学肝脏炎症、肝硬化、肿瘤胞膜、肿瘤分化、微血管侵犯、神经侵犯及淋巴结转移之间有统计学意义(P<0.05)。结论 HBV感染与ICC密切相关,是主要的危险因素,HBV感染导致的长期炎症可能参与ICC发生的机制。

Objective To investigate the intrahepatic cholangiocarcinoma （ICC）, risk factors and pathogenesis. Methods A to- tal of 102 cases of ICC patients as case group, 200 cases of tumor-free physical examination for the control group, com- pared two groups of ICC related factors; and the case group according to the group of HBsAg expression, compared to two sets of clinical and pathological features. Results Between case and control groups, serum HBsAg positive, HBV-related cirrhosis, alcoholic cirrhosis, other causes cirrhosis of the liver and intrahepatic bile duct stones, common bile duct stones and liver fluke disease detection rates were significantly different between the （P 〈 0.05）. HBV-related cirrhosis, alcoholic cir- rhosis of the liver and intrahepatic bile duct stones, and other causes cirrhosis of the liver, serum HBsAg positive for liver fluke disease and ICC closely related （P 〈 0.05）. Serum HBsAg positive group, and serum HBsAg-negative group, age, sex ratio, the level of AFP, CA19-9 level, tumor location, histological inflammation of the liver, cirrhosis of the liver, the tumor cell membrane, tumor differentiation and microvascular invasion, perineural invasion, and lymph node metastasis there are significant differences （P 〈 0.05）. Conclusion HBV infection is closely related to the ICC, is the main risk factors for HBV infection caused by long-term inflammation may be involved in the ICC mechanism.