肝切除术治疗肝内胆管细胞癌的疗效及影响因素分析

Curative Effect and Influencing Factors of Hepatectomy in the Treatment of Intrahepatic Cholangiocarcinoma

目的研究肝切除术治疗肝内胆管细胞癌(ICC)的疗效及影响因素。方法采用回顾性分析研究方法,收集我院2015年4月至2017年4月87例肝内胆管细胞癌患者临床病理资料,所有患者均行肝切除术治疗,分析临床疗效并对影响疗效的因素进行分析。结果 87例患者1、3、5年的复发率分别为42.53%、66.67%、74.71%;1、3、5年的生存率分别为65.52%、40.23%、26.44%;肿瘤直径>5cm、肿瘤多发、发生淋巴结转移、邻近器官侵犯、手术边缘阳性、术前血清黏蛋白CA19-9>35U/ml、血清癌胚抗原(CEA)≤5μg/L、血清甲胎蛋白(AFP)≤25μg/L的肝内胆管细胞癌患者行肝切除术后预后更差(P<0.05)。结论肝切除术是治疗肝内胆管细胞癌的首选方式,肿瘤直径、肿瘤数目、淋巴结转移、邻近器官侵犯、手术边缘以及CA19-9、CEA、AFP水平是影响ICC患者行肝切除术后的危险因素。

Objective To study the curative effect and influencing factors of hepatectomy in the treatment of intrahepatic cholangiocarcinoma(ICC). Methods The clinicopathological data of 87 patients with intrahepatic cholangiocarcinoma treated in our hospital from April 2015 to April 2017 were retrospectively analyzed. All the patients were treated with hepatectomy, and the clinical effects and influencing factors were analyzed. Results Among these 87 patients,the recurrence rates of 1, 3 and 5 years were 42.53%, 66.67% and 74.71%, and the survival rate of 1,3 and 5 years were 65.52%, 40.23% and 26.44%. ICC patients with symptoms as tumor diameter>5 cm, multiple tumors, lymph node metastasis, invasion of neighboring organs, positive surgical margins, preoperative seromucoid CA19-9>35 U/ml,serum carcinoembryonic antigen(CEA)≤5μg/L, serum alpha fetoprotein(AFP) ≤25μg/L had worse prognoses(P<0.05).Conclusion Hepatectomy is the first choice for the treatment of intrahepatic cholangiocarcinoma, and its influencing factors are tumor diameter, tumor numbers, lymph node metastasis, invasion of neighboring organs, surgical margin,and levels of CA19-9, CEA9 and AFP.