Zhang Lei, Cai Jian-qiang, Bi Xin-yu, Zhao Jian-jun, Xing Gu-sheng, Yan Tao, Fu Yu-xia, Zhao Ping
Department of Abdominal Surgical Oncology, Chinese Academy of Medical Sciences, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2009 Nov;31(11):845-8.
To analyze the clinicopathologic factors influencing the outcome of surgically treated intrahepatic cholangiocarcinoma (ICC) and to explore the proper treatment choice of ICC.
The clinicopathological data of 43 surgically treated ICC patients in our hospital were retrospectively analyzed. Of the 43 patients, hepatic resection was performed in 40 patients, ethanol injection in 2, and laparoscopic exploration alone in 1. Kaplan-Meier method and Cox regression model were used for the analysis of factors influencing survival after operation.
The accumulative 1-, 3- and 5-year survival rates were 64.4%, 30.9%, 25.8% for the whole group, and 74.7%, 33.3%, 27.8% for the 40 patients with hepatic resection, respectively. Univariate analysis revealed that tumor size, carcinoembryonic antigen (CEA) level, lymph node involvement and TNM stage were factors significantly affecting the survival (P < 0.05). Cox multivariate analysis demonstrated that only tumor size and lymph node involvement were the independent factors significantly affecting the survival (P < 0.05).
Our results show that tumor size and lymph node involvement are independent factors affecting the survival. CEA level and TNM stage are important prognostic factors for surgical management. Radical resection is still the optimal treatment for patient with intrahepatic cholangiocarcinoma.
分析影响手术治疗肝内胆管癌（ICC）预后的临床病理因素，探讨ICC合适的治疗选择。
回顾性分析我院43例手术治疗的ICC患者的临床病理资料。43例患者中，40例行肝切除术，2例行乙醇注射，1例行单纯腹腔镜探查。采用Kaplan-Meier法和Cox回归模型分析影响术后生存的因素。
全组患者1年、3年和5年累积生存率分别为64.4%、30.9%、25.8%，40例行肝切除术患者的累积生存率分别为74.7%、33.3%、27.8%。单因素分析显示，肿瘤大小、癌胚抗原（CEA）水平、淋巴结转移及TNM分期是影响生存的显著因素（P<0.05）。Cox多因素分析表明，仅肿瘤大小和淋巴结转移是影响生存的独立因素（P<0.05）。
我们的结果表明，肿瘤大小和淋巴结转移是影响生存的独立因素。CEA水平和TNM分期是手术治疗的重要预后因素。根治性切除仍是肝内胆管癌患者的最佳治疗方法。
