Hai Seikan, Kubo Shoji, Yamamoto Satoshi, Uenishi Takahiro, Tanaka Hiromu, Shuto Taichi, Takemura Shigekazu, Yamazaki Osamu, Hirohashi Kazuhiro
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Dig Surg. 2005;22(6):432-9. doi: 10.1159/000091446. Epub 2006 Feb 10.
Although hepatitis C virus (HCV) infection is a possible pathogenetic factor for intrahepatic cholangiocarcinoma (ICC), clinicopathologic features of ICC patients with HCV infection remain unclear.
Of 50 patients with ICC treated, 19 were infected with HCV (HCV-positive group) and 38 underwent surgical treatment. Clinicopathologic features and postoperative outcome were compared between patients with and without HCV infection.
In 15 patients in the HCV-positive group, ICC was detected during follow-up for chronic hepatitis C. The proportion of patients who underwent curative resection was significantly higher in the HCV-positive than in the HCV-negative group, and tumors were significantly smaller in the HCV-positive than in the HCV-negative group. In the HCV-positive group, tumors were significantly smaller in patients who were followed up for chronic hepatitis C than in patients who were not followed up. Although cumulative survival rates did not differ significantly between groups, prognoses of patients with small ICC were significantly better than those with large ICC.
Follow-up for patients with chronic hepatitis C by imaging series at regular intervals is important and provides the possibility to detect a small ICC as well as a hepatocellular carcinoma. Resection should be guided by liver function and the tumor stage in patients with HCV-associated ICC.
尽管丙型肝炎病毒(HCV)感染是肝内胆管癌(ICC)可能的致病因素,但HCV感染的ICC患者的临床病理特征仍不清楚。
在接受治疗的50例ICC患者中,19例感染了HCV(HCV阳性组),38例接受了手术治疗。比较了HCV感染患者和未感染患者的临床病理特征及术后结果。
在HCV阳性组的15例患者中,ICC是在慢性丙型肝炎随访期间发现的。HCV阳性组接受根治性切除的患者比例显著高于HCV阴性组,且HCV阳性组的肿瘤明显小于HCV阴性组。在HCV阳性组中,接受慢性丙型肝炎随访的患者的肿瘤明显小于未接受随访的患者。尽管两组的累积生存率无显著差异,但小ICC患者的预后明显优于大ICC患者。
定期对慢性丙型肝炎患者进行影像学系列随访很重要,这为检测小ICC以及肝细胞癌提供了可能。对于HCV相关ICC患者,应根据肝功能和肿瘤分期指导手术切除。