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目的探讨肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)的预后影响因素。方法回顾性分析52例经病理确诊的ICC患者的临床资料,采用Kaplan-Meier曲线进行生存分析。结果52例患者中,男性占82.7%;HBV感染者占75.0%;Child-Pugh分级为A级90.4%,B级9.6%;AJCC分期Ⅰ~Ⅱ期占67.3%,Ⅲ~Ⅳ期占32.7%;行根治性手术者占32.7%。生存分析显示,有肝病家族史、确诊时有症状、AJCC分期晚、肿瘤分化程度低、乙肝病毒DNA载量≥1000 IU/ml的患者生存期明显降低。肝移植、根治性肝癌切除、局部治疗的患者中位生存期分别为24(19,48)个月、17(8,38)个月、8(3,24)个月。结论肝病家族史、确诊时有症状、AJCC分期、肿瘤分化程度、乙肝病毒DNA载量是ICC患者生存的影响因素。早期诊断ICC,接受根治性治疗,有可能改善预后。
Objective To investigate the prognostic factors of intrahepatic cholangiocarcinoma (ICC). Methods The clinical data of 52 pathologically confirmed ICC patients were retrospectively analyzed. Kaplan-Meier curves were used for survival analysis. Results Among 52 patients, 82.7% were male, 75.0% were HBV infected, Child-Pugh was grade A 90.4% and Grade B 9.6%, AJCC stage Ⅰ-Ⅱ 67.3%, stage Ⅲ-Ⅳ 32.7% ; Radical surgery accounted for 32.7%. Survival analysis showed that the survival of patients with a family history of liver disease, diagnosis of symptoms, late AJCC stage, low degree of tumor differentiation, hepatitis B virus DNA load ≥ 1000 IU / ml significantly decreased survival. The median survival was 24 (19,48) months, 17 (8,38) months, and 8 (3,24) months for liver transplantation, radical liver resection and topical treatment, respectively. Conclusion Family history of liver disease, diagnosis of symptoms, AJCC staging, tumor differentiation, DNA load of hepatitis B virus are the influencing factors for the survival of ICC patients. Early diagnosis of ICC, receiving radical treatment, may improve the prognosis.