|
|
|
|
Logistic regression analysis of risk factors affecting prognosis of
patients with intrahepatic cholangiocarcinoma surgery |
| YANG Juan, MU Qi-ming, TAN Qin |
| (Department of Hepatobiliary and Pancreatic Surgery, AVLC 363 Hospital, Chengdu Sichuan 610041,China)
(Department of Hepatobiliary and Pancreatic Surgery, AVLC 363 Hospital, Chengdu Sichuan 610041,China)
|
|
|
|
|
Abstract Objective: To figure out the highrisk factors for postoperative recurrence／metastasis in patients with intrahepatic cholangiocarcinoma(ICC). Methods: The clinical data of 128 patients with ICC were retrospectively analyzed. According to the recurrence／metastasis within 3 years after operation, the patients were divided into poor prognosis group(n=60) and control group(n=68). Univariate comparison was used to compare the baseline data, surgical treatment, tumor pathology and biochemical indicators in the two groups, and the indicators with statistical significance were included in the unconditional Logistic binary regression model to screen out the independent risk factors for postoperative recurrence and metastasis. Results: Tumor diameter≥5 cm, portal vein positive infiltration, positive lymph node metastasis, high BismuthCorlette hilar cholangiocarcinoma classification and carbohydrate antigen 199 (CA199)≥150 U／mL were the independent risk factors for postoperative poor prognosis of patients with ICC(P<0.05). Conclusion: Tumor pathology conditions of tumor diameter, portal vein infiltration, lymph node metastasis and BismuthCorlette classification and serum tumor marker of CA199 can independently have a profound impact on the prognosis of patients with ICC surgery.
|
|
Received: 27 February 2019
|
|
|
|
| ［1］崔忠,赵清涛,孙建斌,等.肝内胆管囊腺癌患者预后影响因素分析［J］.解放军预防医学杂志,2017,35(6):652-654.［2］刘芙蓉,林月明,何晓顺,等.肝门部胆管癌患者行肝移植和根治切除术后生存结果的对比分析［J］.中华医学杂志,2015,95(26):2109-2113.［3］段松,杨杰斌,石丹,等.EPCAM、NCAM1及CKIT与原发性肝癌分级、转移及患者预后的关系［J］.医学分子生物学杂志,2018,15(5):338-343.［4］中华医学会外科学分会胆道外科学组.肝门部胆管癌诊断和治疗指南(2013版)［J］.中华外科杂志,2013,51(10):865-871.［5］曾玉萍,梁治平,曾旭文,等.肝细胞癌合并胆管癌栓与肝门部胆管癌临床特点比较［J］.广东医学,2018,39(14):2183-2185,2189.［6］Paul A, Kaiser GM, Molmenti EP, et al. Klatskin tumors and the accuracy of the BismuthCorlette classification［J］. Am Surg, 2011, 77(12):1695-1699.［7］殷晓煜,刘鑫,陈伟,等.肝门部胆管癌手术切除的远期疗效及预后因素分析［J］.中华消化外科杂志,2016,15(4):329-334.［8］胡海洁,靳艳文,林圯昕,等.肝门部胆管癌肿瘤直径及相关预后指标对患者预后的影响因素分析［J］.中华消化外科杂志,2018,17(3):266-272.［9］鲁正,王冬冬.BismuthCorlette Ⅲ、Ⅳ型肝门部胆管癌的手术治疗方式［J］.中华外科杂志,2016,54(7):488-491.［10］黎蕴通,曾永毅.肝内胆管癌的腹腔淋巴结清扫［J］.临床外科杂志,2017,25(6):417-419.［11］余安,黄强,刘臣海,等.联合门静脉切除及重建治疗肝门部胆管癌临床疗效的Meta分析［J］.中华消化外科杂志,2017,16(1):65-70.［12］Conci S, Ruzzenente A, Sandri M, et al. What is the most accurate lymph node staging method for perihilar cholangiocarcinoma? Comparison of UICC／AJCC pN stage, number of metastatic lymph nodes, lymph node ratio, and log odds of metastatic lymph nodes［J］. Eur J Surg Oncol,2017, 43(4):743-750.［13］蒋安科,李强,李博,等.CA199和CEA在肝胆管结石合并胆管癌诊断与预防评估中的价值［J］.肝脏,2015,20(11):862-864.［14］查育锋,何晓虎,田勉,等.糖链抗原199对可切除肝门部胆管癌患者预后及早期复发的预测价值［J］.临床肝胆病杂志,2018,34(5):141-146.［15］李辽,王金,尚培中.膜联蛋白A1和CA199在胆管癌中的表达及其临床意义［J］.中国现代医学杂志,2016,26(10):31-35. |
|
|
|
2019, Vol. 29 
