Chou F F, Sheen-Chen S M, Chen C L, Chen Y S, Chen M C
Department of Surgery, Chang Gung Medical College, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan.
J Surg Oncol. 1995 May;59(1):40-4. doi: 10.1002/jso.2930590111.
Intrahepatic cholangiocarcinoma is a rare disease. The prognostic factors of resectable cholangiocarcinoma have not been previously reported. Nineteen patients (10M, 9F) with resectable cholangiocarcinoma were investigated to find factors that might influence prognosis. The cumulative survival rate was measured using the Kaplan-Meier method. The log-rank test was used to compare two survivals. Age, sex, tumor size, and positive tissue carcinoembryonic antigen were factors that had no influence on prognosis. Patients with a positive HLA-DR, a well-differentiated carcinoma, and a clear resective margin had better prognoses but were statistically undifferentiatable from the other patients. Patients with positive hilar lymph nodes had poor prognoses (P < 0.01), whereas patients with positive mucobilia had good prognoses (P < 0.05). Positive staining for HLA-DR on tumor cells was observed in nine of 19 cases of intrahepatic cholangiocarcinoma. The positive HLA-DR staining correlated with a better prognosis, but no significant difference was noted between the positive and negative HLA-DR staining group. A positive hilar lymph node was a grave sign, as almost all patients of positive lymph node died within 9 months after operation. Positive mucobilia was a good prognostic sign that correlated with the long-term survival.
肝内胆管癌是一种罕见疾病。可切除胆管癌的预后因素此前尚未见报道。对19例（10例男性，9例女性）可切除胆管癌患者进行研究，以寻找可能影响预后的因素。采用Kaplan-Meier法测定累积生存率。采用对数秩检验比较两种生存率。年龄、性别、肿瘤大小和组织癌胚抗原阳性对预后无影响。HLA-DR阳性、高分化癌且切缘清晰的患者预后较好，但与其他患者相比无统计学差异。肝门淋巴结阳性的患者预后较差（P<0.01），而胆汁黏液阳性的患者预后较好（P<0.05）。19例肝内胆管癌患者中有9例肿瘤细胞HLA-DR染色呈阳性。HLA-DR染色阳性与较好的预后相关，但HLA-DR染色阳性组与阴性组之间无显著差异。肝门淋巴结阳性是一个严重迹象，因为几乎所有淋巴结阳性患者在术后9个月内死亡。胆汁黏液阳性是与长期生存相关的良好预后迹象。
