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年轻患者肝内胆管细胞癌的病因学和临床病理特征。

Etiological and clinicopathologic characteristics of intrahepatic cholangiocarcinoma in young patients.

机构信息

Department II of Comprehensive Treatment, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.

出版信息

World J Gastroenterol. 2010 Feb 21;16(7):881-5. doi: 10.3748/wjg.v16.i7.881.

Abstract

AIM

To investigate the prevalence, risk factors, and clinicopathologic characteristics of intrahepatic cholangiocarcinoma (ICC) in young patients.

METHODS

A retrospective analysis was performed in ICC patients referred to the Eastern Hepatobiliary Surgery Hospital in Shanghai, China. Among 317 consecutively enrolled patients, 40 patients were aged <or= 40 years (12.61%). We compared the risk factors and clinicopathologic characteristics of these patients (group I: n = 40) with those aged > 40 years (group II: n = 277).

RESULTS

Group I had distinct features compared with group II, including a low frequency of hepatolithiasis (P = 0.000); a high positive rate of serum hepatitis B surface antigen (P = 0.000) and hepatitis B virus (HBV)-associated cirrhosis (P = 0.038); a high frequency of alpha-fetoprotein (> 400 microg/L) (P = 0.011); a low frequency of carbohydrate antigen 19-9 (> 37 U/mL) (P = 0.017); and a high frequency of liver histological inflammation (P = 0.002). Although there was no significant difference between the two groups in regards to hepatic schistosomiasis, alcohol-associated cirrhosis and cirrhosis due to other causes (P > 0.05), they only occurred in the elderly group.

CONCLUSION

The risk factors are significantly different between young and elderly ICC patients. HBV and HBV-associated cirrhosis are the most important risk factors for young ICC patients.

摘要

目的

研究青年患者肝内胆管细胞癌(ICC)的流行率、危险因素和临床病理特征。

方法

对中国上海东方肝胆外科医院收治的 ICC 患者进行回顾性分析。在连续纳入的 317 例患者中,40 例患者年龄<或=40 岁(12.61%)。我们比较了这些患者(I 组:n=40)与年龄>40 岁患者(II 组:n=277)的危险因素和临床病理特征。

结果

与 II 组相比,I 组具有明显的特征,包括肝胆管结石的发生率较低(P=0.000);乙型肝炎表面抗原(HBsAg)和乙型肝炎病毒(HBV)相关肝硬化的阳性率较高(P=0.000)(P=0.038);甲胎蛋白(AFP)>400μg/L 的频率较高(P=0.011);碳水化合物抗原 19-9(CA19-9)>37U/mL 的频率较低(P=0.017);肝组织炎症的频率较高(P=0.002)。虽然两组之间在肝血吸虫病、酒精相关性肝硬化和其他原因导致的肝硬化方面无显著差异(P>0.05),但这些情况仅发生在老年组。

结论

青年和老年 ICC 患者的危险因素有显著差异。HBV 和 HBV 相关肝硬化是青年 ICC 患者最重要的危险因素。

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