多倍体肿瘤巨细胞与肝内胆管细胞癌临床病理学特征及预后研究

The correlation between polyploid giant cancer cells and clinical pathological characteristics and prognosis of intrahepatic cholangiocarcinoma

目的 探讨多倍体肿瘤巨细胞(PGCC)阳性肝内胆管细胞癌(ICC)病人的临床病理特征及其对预后的影响。方法 回顾性分析2005年6月至2019年6月在天津医科大学肿瘤医院接受手术的72例ICC病人的临床病理学资料,应用HE染色组织病理学分析ICC中PGCC的分布和比例,通过多变量回归分析探索PGCC与ICC临床病理学特征及术后总生存期(OS)和无复发生存期(DFS)的关系。结果 在72例ICC中,血管侵犯和术前总胆红素水平是影响ICC预后OS的独立危险因素;PGCC是影响ICC预后DFS的独立危险因素,手术切除样本中PGCC阳性ICC病人的DFS劣于PGCC阴性的病人(P<0.01)。进一步的Logistic多因素分析表明PGCC与ICC的病理学分期和肿瘤的分化程度密切相关。Ⅱ~Ⅲ期病人较Ⅰ期病人具有更高的PGCC比例(P=0.006);同时低分化的ICC较中-高分化的ICC具有更高的PGCC比例(P=0.032)。结论 PGCC与ICC病人预后不良密切相关,是影响胆管癌病人DFS的独立危险因素,有望成为评估胆管癌预后生存及指导临床诊疗的新指标。

Objective To investigate the clinicopathological characteristics of patients with polyploid giant cancer cells(PGCC)-positive intrahepatic cholangiocarcinoma(ICC)and their effect on prognosis.Methods The clinicopathological information of 72 ICC patients who underwent surgery at Tianjin Medical University Cancer Hospital from June 2005 to June 2019 was retrospectively analyzed.The distribution and proportion of PGCC in ICC were assessed through histopathology using HE staining.Multivariate regression analysis was employed to explore the clinicopathological features of PGCC and ICC,as well as their overall survival(OS),and disease-free survival(DFS).Results Among the 72 ICC cases,independent risk factors affecting the prognostic OS of ICC were identified as vascular invasion and preoperative total bilirubin levels.PGCCs were identified as an independent risk factor for prognostic DFS in ICC.PGCC-positive ICC patients in surgical resection samples exhibited significantly lower DFS compared to PGCC-negative patients(P<0.01).Logistic multivariate analysis demonstrated a close correlation between PGCC presence and ICC pathological stage,as well as tumor differentiation degree.StageⅡ-Ⅲpatients had a higher proportion of PGCCs compared to stageⅠpatients(P=0.006),and poorly differentiated ICC showed a higher PGCC ratio than moderately to highly differentiated ICC(P=0.032).Conclusion PGCCs were closely associated with poor prognosis in ICC patients and emerged as independent risk factors influencing DFS in cholangiocarcinoma.These findings highlight the potential for PGCCs to serve as a novel indicator for evaluating prognosis and survival,as well as guiding clinical decisions in cholangiocarcinoma management.