阳性淋巴结个数对肝内胆管细胞型肝癌患者术后生存的影响

Numbers of positive lymph nodes predict postoperative survival of intrahepatic cholangiocellular carcinoma patients after radical resection

目的探讨转移淋巴结个数对肝内胆管细胞癌患者术后生存的影响。方法回顾性分析2013年2月至2019年10月于本院肝胆胰外科行根治性手术切除术90例患者的临床资料,37例无淋巴结转移者为N0组,21例转移淋巴结<3枚,为N1组;32例≥3枚,为N2组。采用Kaplan-Meier法构建生存曲线;COX回归分析筛选影响生存的危险因素。结果N0组37例,术后1、3年生存率分别为57.7%、35.2%;N1组21例,1、3年生存率分别为46.7%、17.5%;N2组32例,1、3年生存率分别为19.6%、0;三组间总体生存率差异比较有统计学意义(χ^(2)=15.272,P=0.001)。多因素分析显示边缘状态(P=0.009)、阳性淋巴结个数(P=0.002)是影响患者预后的独立危险因素。结论边缘状态及淋巴结转移数量与肝内胆管细胞型肝癌根治术后生存密切相关。

Objective To evaluate prognostic significance of metastated lymph nodes(LN)in patients with intrahepatic cholangio carcinoma(ICC)after radical resection.Methods Data were reviewed on 90 patients at Department of Hepatobiliary and Pancreatic Surgery in our hospital from Feb 2013 to Oct 2019,37 cases had no LN metastasis(N0 group),21 cases were in N1 group(positive LN<3)and 32 cases in N2 group(positive LN≥3),and Kaplan-Meier method was used to construct survival curve.Univariate and multivariate COX regression analysis was used to screen independent risk factors.Results In N0 group the 1-and 3-year survival rates were 57.7%and 35.2%,respectively.In N1 group the 1-and 3-year survival rates were 46.7%and 17.5%,respectively in N2 group.the 1-and 3-year survival rates were 19.6%and 0,respectively.There was statistical significance in overall survival rate among the three groups(χ^(2)=15.272,P<0.05).Multivariate analysis showed that resection margin(P=0.009)and the number of positive LN(P=0.002)were independent risk factors affecting the prognosis of patients.Conclusion Resection margin and the number of metastasing LN were closely related to postoperative prognosis of ICC patients.