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目的 探讨影响胆管癌预后的因素。方法 回顾性分析文献报道胆管癌的临床资料。结果与结论 上段胆管癌预后最差 ,中段次之 ,下段较好。分化程度高 ,预后好 ,反之 ,预后差。合并转移者生存期比未转移者短。二倍体组的预后比高倍体组好。增殖细胞核抗原 (PCNA )高增殖组生存期显著低于PCNA低增殖组。上皮膜抗原 (EMA)、细胞内角蛋白 (CK )阴性胆管癌预后不良。Ⅳ型胶原酶活性与肿瘤转移能力呈平行关系。nm2 3与肿瘤的侵袭性、淋巴转移潜能及预后有关。根治性切除术疗效最好 ,姑息性切除术次之 ,胆肠吻合内引流或外引流效果差。局部放疗效果有限。化疗对生存期无影响。早期诊断 ,争取胆管癌根治或扩大根治术 ;综合治疗等有望改善预后
Objective To explore the factors affecting the prognosis of cholangiocarcinoma. Methods Retrospective analysis of the clinical data of the literature on cholangiocarcinoma. Results and Conclusions The prognosis of the upper bile duct carcinoma was the worst, followed by the middle segment and the lower segment. A high degree of differentiation, a good prognosis, on the contrary, the poor prognosis. The lifetime of merger metastasis is shorter than that of non-metastatic person. The prognosis of the diploid group was better than that of the hyperploid group. The proliferative cell nuclear antigen (PCNA) high proliferation group had significantly lower survival than the PCNA low proliferation group. Epithelial membrane antigen (EMA) and intracellular keratin (CK) negative cholangiocarcinoma have a poor prognosis. Type IV collagenase activity is parallel to tumor metastasis. Nm23 is associated with tumor invasiveness, lymphatic metastasis potential, and prognosis. The curative effect of radical resection is best, followed by palliative resection, and the effect of drainage or external drainage in choledochal anastomosis is poor. The effect of local radiotherapy is limited. Chemotherapy has no effect on survival. Early diagnosis for radical or radical mastectomy; comprehensive treatment is expected to improve prognosis