不同病因肝内胆管癌行肝切除术预后与年龄的关系

Relationship between age and outcome of intrahepatic cholangiocarcinoma of different causative factors

目的:探讨不同病因的肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)患者行肝切除术预后与年龄之间的关系。方法:对东方肝胆外科医院2004至2010年期间行R0切除术的606名肝内胆管癌患者进行分析。将患者分为乙肝相关组(HBV-ICC,n=456),结石相关组(stone-ICC,n=75)及其他病因组(other-ICC,n=85)。按年龄分为青年组(<40岁)、中年组(40~60岁)及老年组(>60岁)。分别对不同年龄段不同病因的患者进行生存分析对比。结果:青年组及老年组两种病因的总生存期差异无统计学意义(P=0.236,P=0.151);而中年组两种病因总生存期差异有统计学意义(P=0.002);青年组及老年组两种病因的复发率差异无统计学意义(P=0.169,P=0.126),而中年组复发率差异有统计学意义(P=0.003)。结论:在不同年龄段的患者中,不同病因肝内胆管癌切除术后的生存及复发均存在差异。

Objective:To evaluate the impact of different causative factors of intrahepatic cholangiocarcinoma(ICC)on disease outcome related to age.Methods:Date of 606 consecutive patients undergoing R0 liver resection for ICC at the Eastern Hepatobiliary Surgery Hospital between 2004 and 2010 were analyzed.These patients were divided into a hepatitis B virus-related(HBV-ICC,n=456),a hepatolithiasis-related(stone-ICC,n=75),and an other etiologies-related(other-ICC,n=85)ICC groups.Patients were classified into 3 groups by age bracket;younger group(<40 years),middle-aged group(40–60 years),and elderly group(above 60 years).Results:The differences of overall survival in the younger group and the elderly group were all not statistically significant(P=0.236,P=0.151),while in the middle-aged group it was significant(P=0.002).Recurrence in the younger group and the elderly group showed no significant difference(P=0.169,P=0.126),but existed significance in the middle-aged group(P=0.003).Conclusion:In different age-related groups,outcome of different causative factors of ICC exist differences.