中国普外基础与临床杂志

中国普外基础与临床杂志

41 例混合型肝癌的临床特征与预后分析

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目的 分析混合型肝癌(combined hepatocellular-cholangiocarcinoma,CHCC)病例的临床资料,探讨其临床特点和预后。 方法 回顾性分析 41 例行根治性切除的 CHCC 病例资料,对影响其预后的相关因素进行统计学分析。 结果 41 例 CHCC 患者中,AFP 和 CA19-9 均升高者 15 例(36.6%),CK7 和(或)CK19 与 Glypcian-3 和(或)Hepatocyte 均呈阳性表达者 32 例(78.0%)。多因素分析结果显示,淋巴结受侵是影响 CHCC 患者预后的独立危险因素。 结论 CHCC 是一种特殊的原发性肝癌,临床特征兼具肝细胞癌和胆管细胞癌的特点。受侵淋巴结的残留可能影响患者长期生存,现阶段的治疗方式应该个体化。

Objective To study the data of combined hepatocellular cholangiocarcinoma (CHCC) and to explore its clinical characteristics and prognostic factors. Methods Clinical data of 41 patients with radical resection of CHCC were retrospectively analyzed, and the prognostic factors were analyzed by univariate and multivariate analysis. Results In 36.6% cases of 41 patients with CHCC, the elevated levels of both AFP and CA19-9 were detected. And 78.0% cases got the elevated levels of CK7 and (or) CK19 and Glypcian-3 and (or) hepatocyte. Multiple analysis revealed lymph node involvement was independent prognostic factor for overall survival. Conclusions CHCC is a special type of primary liver cancer and shows some intermediated characteristics between hepatocellular carcinoma and cholangiocarcinoma. The long-term survival of the patients should be affected by the residual of metastasis lymph nodes, and the surgical treatment should be individualized at the present stage.

关键词: 混合型肝癌; 临床特征; 预后

Key words: combined hepatocellular cholangiocarcinoma;