摘要
目的分析混合型肝癌的临床病理特点并研究影响患者手术预后的相关因素。方法回顾性分析我科2005年5月—2014年10月收治的经手术切除，病历资料完整，获得随访的72例混合型肝癌患者资料。对其预后相关因素进行Kaplan—Meier单因素和Cox多因素分析。结果72例患者术前均未确诊，均由术后病理确诊为混合型肝癌。患者中位年龄为51岁，男性57例，女性15例；伴肝硬化60例，乙肝表面抗原阳性62例，癌胚抗原（CEA）≥5μg／L8例，CA19—9≥37U／ml34例。术后1、3、5年生存率分别为67．7％、38．3％、19．3％。单因素分析结果显示：CE≥5μg／L（P〈0．001）、CA19—9≥37U／ml（P〈0．001）、脉管癌栓（P=0．003）、糖尿病（P=0．044）、术后病理切缘阳性（P〈0．001）是影响患者预后的危险因素。多因素分析结果显示：切缘阳性（P=0．016）和CA19—9≥37U／ml（P=0．010），癌胚抗原（CEA）≥5μg／L（P=0．005）是影响患者预后的独立危险因素。结论混合型肝癌患者总体预后差，CEA≥5μg／L，切缘阳性，CA19—9≥37U／ml是影响患者预后的独立危险因素。
Objective To analyze the pathological features of patients with combined hepatocellular cholangiocarcinoma （ cHCC - CC） and investigate the related factor of prognosis after surgery. Methods A total of 72 cHCC - CC patients who underwent surgery in our department from May 2005 to October 2014 were included into the current study. Their clinical data were retrospectively analyzed. Then, related prognostic factors were analyzed according to the Kaplan - Meier method and the Cox model. Results All the patients were pathologically diagnosed with cHCC - CC after surgery. The median age was 51 years old, with 57 men and 15 women. There were 60 eHCC - CC patients with liver cirrhosis, 62 with positive HbsAg, 8 with ≥5μg/L of serum carcino - embryonic antigen （CEA） and 34 with ≥ 37 U/ml CA19 -9. The survival rate was 67.7% one year after surgery, 38.3% three years after surgery and 19.3% five years after surgery. According to the single factor analysis, the related prognostic factors of cHCC - CC patients included vessel invasion （ P = 0.003 ）, CA19 - 9≥37 U/ml （ P 〈 0.001 ）, CEA ≥5 μg/L （ P 〈 0.001 ）, positive resection margin （ P 〈 0.001 ）, and diabetes （ P = 0. 044 ）. Multivariate analysis resuhs showed that positive resection margin （ P = 0. 016 ）, CA19 -9 ≥37 U/ml （P =0.010） , and CEA≥5 μg/L （P =0. 005） were the independent risk factors of cHCC - CC patients after surgery. Conclusions Patients with cHCC - CC show generally poor prognosis. Positive resection margin, CA19 -9≥37 U/m1, and CEA≥5 μg/L are the independent risk factors of cHCC -CC patients after surgery.
出处
《徐州医学院学报》
CAS
2017年第2期91-94,共4页
Acta Academiae Medicinae Xuzhou
关键词
原发性肝癌
混合型肝癌
预后
生存分析
primary liver cancer
combined hepatocellular cholangiocarcinoma
prognosis
survival analysis
