Departments of Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan.
World J Surg. 2012 Mar;36(3):645-50. doi: 10.1007/s00268-011-1413-z.
In the present study we undertook a retrospective analysis of gallbladder carcinoma to assess whether histologically determined hepatic artery (HA) invasion and portal vein (PV) invasion can be considered prognostic factors.
Seventy-one patients who had undergone radical resection for gallbladder carcinoma between 1995 and 2008 at University of Tsukuba were selected from the database for analysis. Patients who required extended surgery for para-aortic lymph node metastasis were also included. Correlation between invasion of the HA and the PV and prognosis and other clinicopathologic factors were analyzed.
There were two postoperative deaths among the 71 patients. Pathological invasion of the HA was confirmed in 16 (22.5%) cases and PV invasion was confirmed in 15 patients. Patients with invasion of the HA had a significantly poorer prognosis than those without HA invasion (P < 0.0001). Additionally, in univariate analysis, gender (male), positive para-aortic lymph node metastasis, PV invasion, and HA invasion were identified as significant poor prognostic factors. In multivariate analysis, only HA invasion was an independent prognostic factor (Odds Ratio 0.323; P = 0.029).
Invasion of the HA is a crucial prognostic factor in patients with gallbladder carcinoma.
在本研究中，我们对胆囊癌进行了回顾性分析，以评估组织学确定的肝动脉（HA）浸润和门静脉（PV）浸润是否可以视为预后因素。
从筑波大学数据库中选择了 1995 年至 2008 年间接受根治性胆囊切除术的 71 例患者进行分析。还包括需要进行主动脉旁淋巴结转移扩大手术的患者。分析了 HA 和 PV 浸润与预后以及其他临床病理因素的相关性。
71 例患者中有 2 例术后死亡。16 例（22.5%）患者的 HA 有病理学浸润，15 例患者的 PV 有病理学浸润。HA 浸润的患者预后明显差于无 HA 浸润的患者（P < 0.0001）。此外，单因素分析显示，性别（男性）、阳性主动脉旁淋巴结转移、PV 浸润和 HA 浸润是显著的预后不良因素。多因素分析显示，只有 HA 浸润是独立的预后因素（优势比 0.323；P = 0.029）。
HA 浸润是胆囊癌患者的重要预后因素。
