肝炎病毒相关肝内胆管细胞癌的流行病学特点分析92例

Hepatitis virusrelated intrahepatic cholangiocarcinoma: Analysis of 92 cases

目的:探讨病毒相关肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)的临床流行病学特点.方法:回顾性分析92例经病理确诊的ICC患者临床流行病学特点,对肝炎病毒相关ICC与非病毒感染ICC特点进行比较.结果:92例ICC患者以男性为主,发病年龄54.29岁±12.09岁,肝炎组患者65例,非肝炎组27例;肝炎组男性患者发病年龄明显早于非肝炎组;肝炎组患者中47.69%于体检时发现肝占位而确诊,比例高于非肝炎组(18.51%);肝炎组甲胎蛋白(alpha-fetoprotein,AFP)阳性的患者比例(49.23%)显著高于非肝炎组(14.81%),而糖链抗原199阳性率(33.85%)则低于非肝炎组患者(74.07%).肝炎患者中乙型肝炎病毒(hepatitis B virus,HBV)感染占92.31%,其中以乙型肝炎E抗原(hepatitis B e antigen,HBeAg)阴性患者为主;有抗病毒史的乙型肝炎患者仅有1/4.本组ICC患者中肝硬化比例为60%.结论:肝炎病毒慢性感染是ICC发病的重要危险因素,研究肝炎病毒对ICC发生和预后的影响将为进一步有效干预提供依据.

AIM： To explore the clinical and epidemiological characteristics of hepatitis virus-associated intra- hepatic cholangiocarcinoma （ICC）. METHODS： A retrospective analysis of clinical and epidemiological data for 92 patients with pathologically confirmed ICC was conducted. The data between patients with virus-associated ICC and those with non-virus-associated ICC were compared. RESULTS： The mean age of the 92 patients was 54.29 ± 12.09 years, and there were more male patients. Sixty-five cases were in the hepatitis group and 27 cases in the non-hepatitis group. Male patients in the hepatitis group had sig- nificantly earlier age of onset than those in the non-hepatitis group. About 47.69% of patients in the hepatitis group and 18.51% of patientsin the non-hepatitis group were diagnosed on physical examination and there was a signifi- cant difference in the percentage between the two groups. Alpha-fetoprotein （AFP） positive rate in the hepatitis group （49.23%） was sig- nificantly higher than that in the non-hepatitis group （14.81%）, while CA199 positive rate in the hepatitis group （33.85%） was significantly lower than that in the non-hepatitis patients （74.07%）. HBV infection accounted for 92.31% of the patients with hepatitis, who were mainly HBeAg-negative patients. There was only 1/4 of patients with prior anti-hepatitis B virus therapy. The proportion of patients with liver cirrhosis was about 60% among all ICC patients. CONCLUSION： Chronic hepatitis virus infection is an important risk factor for the onset of ICC. The exploration of effect of hepatitis virus infec- tion on the occurrence and prognosis of ICC will further provide clues for effective intervention.