胆管细胞癌术前血液学指标与预后相关性分析

Correlation analysis of preoperative hematological parameters and prognosis of patients with cholangiocarcinoma who underwent radical surgery

目的探讨行根治性手术的胆管细胞癌(CCA)患者术前血液学指标与预后之间相关性及影响预后的因素分析。方法回顾性分析中国人民解放军总医院10年间288例根治性手术后病理确诊为CCA患者的术前血液学、临床病理及总生存时间(OS)数据,利用Kaplan-Meier法绘制生存曲线进行分析,并用χ^(2)检验分析术前血液学指标与预后之间相关性。结果288例完成根治性手术的CCA患者,术前较低糖链抗原19-9(CA19-9)、总胆汁酸(TBA)、碱性磷酸酶(ALP)值与预后(OS≥24个月)具有相关性(P=0.001,P=0.004,P<0.001)。单因素分析示TBA、ALP、CA19-9、肝硬化、TNM分期与预后相关,具有统计学意义(P=0.008,P<0.001,P<0.001,P=0.002,P<0.001),COX回归多因素分析发现ALP(P=0.003)、CA19-9(P=0.016)、肝硬化(P=0.012)、TNM分期(P<0.001)是影响预后的独立因素。结论术前CA19-9、TBA、ALP与2年OS存在相关性,CA19-9、ALP、肝硬化、TNM分期是CCA患者根治术后预后评估的独立因素。

Objective To explore the correlation between preoperative hematological parameters and prognosis in patients with cholangiocarcinoma(CCA)undergoing radical surgery and analyze the factors affecting prognosis.Methods Retrospective analysis of preoperative hematology,clinical pathology and overall survival(OS)data of 288 patients with CCA who were diagnosed by radical surgery,which from the Chinese PLA General Hospital in the past 10 years.Survival curves were plotted by Kaplan-Meier method,Chi-square test was used for preoperative hematological indicators and prognosis.Results Chi-square test was used in 288 cases of radical surgery CCA to found Carbohydrate antigen 19-9(CA19-9),total bile acid(TBA)and alkaline phosphatase(ALP)lower values were correlated with better prognosis(OS≥24 months)(P=0.001,P=0.004,P<0.001).Univariate analysis showed that TBA,ALP,CA19-9,cirrhosis and TNM stage(P=0.008,P<0.001,P<0.001,P=0.002,P<0.001)were statistically significant for prognostic analysis,and COX regression multivariate analysis found ALP(P=0.003),CA19-9(P=0.016),cirrhosis(P=0.012)and TNM stage(P<0.001)were independent prognostic factors.Conclusions Preoperative CA19-9,TBA and ALP were related to 2 years OS,CA19-9,ALP,cirrhosis and TNM stage are independent factors for the prognosis of CCA after radical surgery.