影响肝内胆管细胞癌的预后相关临床因素探讨

Analysis of Prognostic Factors of Affecting Intrahepatic Cholangiocarcinoma

目的 探讨肝内胆管细胞癌（ICC）患者术后的预后相关的临床影响因随。方法 分析2001年1月~2011年12月肿瘤科诊断并治疗的98例ICC患者的临床资料。采用Kaplan-Meier法进行生存率的单因素分析,Log-rank法进行各组间生存率的比较;采用Cox回归分析模型进行多因素分析。结果 98例入选患者的1年、3年、5年的生存率分别为54.07%、32.40%、19.82%。根治性手术患者、姑息性手术患者和非手术患者的中位生存期分别为37个月、21个月和6个月。单因素分析显示无肝吸虫病史、术前血清AFP、CA199、CEA、总胆红素、AST水平是ICC患者术后预后的影响因素,多因素分析显示,ICC患者术前血清CEA、血清CA199、总胆红素为术后预后的独立影响因素。结论 根治性切除手术是ICC病人获得长期生存的重要的治疗手段,能够提高患者的生存率。血清CEA、血清CA199、总胆红素是ICC病人术后预后的重要的影响因素。

Objective To explore the prognostic factors of intrahepatic cholangiocarcinoma（ICC） undergoing hepa- tectomy. Methods Clinical data of 98 patients with pathologically confirmed ICC treated at cancer center, fromjanuary 2001 to December 2011 were reviewed. Survival and prognosis were analyzed by Kaplan -meier method and cox regres- sion model. Results The ! - ,3 - and 5 - year survival rates of the 98apatients were 54. 07% ,32. 40% and 19. 82%, respectively. The univariate statistical analysis showed that serum level of AFP, CA199, CEA,TB and AST affected post- operative survival; whereas multivariate analysis found that serum level of CA199, CEA and TB wrer the independent prognostic factor. Conclusions Radical resection is the main effective treatment for ICC patoents to achieve long - term survival. Preoperative serum levels of CA199, CEA and TB are significant prognostic factor for patients with respectable ICC.