论文部分内容阅读
目的探讨意外胆囊癌的临床处理对策与预后。方法回顾性分析意外胆囊癌51例,对其治疗与预后进行统计分析。生存分析采用Kaplan-Meier法,组间比较采用Log-rank检验,多因素分析采用Cox比例风险模型。结果多因素分析表明肿瘤位置、Nevin分期及手术方式是影响预后的独立因素;对于Ⅱ期体底部胆囊癌和Ⅲ、Ⅳ期体底部胆囊癌以及颈部胆囊癌,胆囊癌根治术组优于单纯胆囊切除术组,其差异有统计学意义(P值分别为0.014、0.001及0.018);对于Ⅰ期体底部胆囊癌,单纯胆囊切除术组与胆囊癌根治术组病人的生存率差异无统计学意义(P=0.312)。结论对于NevinⅠ期体底部胆囊癌病人,单纯胆囊切除术已达到根治效果;对于NevinⅠ期颈部胆囊癌及NevinⅡ期以晚的胆囊癌,胆囊癌根治术能有效改善其预后。
Objective To investigate the clinical treatment and prognosis of unexpected gallbladder cancer. Methods Retrospective analysis of 51 cases of unexpected gallbladder cancer, the treatment and prognosis of the statistical analysis. Kaplan-Meier method was used for survival analysis, Log-rank test was used for comparison between groups, and Cox proportional hazards model was used for multivariate analysis. Results Multivariate analysis showed that the location of neoplasms, Nevin staging and operation method were independent prognostic factors. For the gallbladder carcinoma of the bottom of stage Ⅱ and the gallbladder carcinoma of the bottom of stage Ⅲ and Ⅳ, as well as the gallbladder carcinoma of the neck and gallbladder carcinoma, The difference was statistically significant (P = 0.014,0.001 and 0.018, respectively) for cholecystectomy group. There was no significant difference in the survival rate between the cholecystectomy group and gallbladder radical operation group Significance (P = 0.312). Conclusions For patients with gallbladder carcinoma of the bottom of Nevin stage Ⅰ, simple cholecystectomy has achieved the curative effect. For Nevin stage Ⅰ gallbladder cancer and Nevin Ⅱ stage of gallbladder cancer, gallbladder carcinoma can effectively improve its prognosis.