| 摘要: |
| 目的 探讨HBV感染对肝内胆管细胞癌（ICC）预后的影响。方法 回顾性分析2015年10月至2019年12月于我院安亭院区入院治疗的162例经手术或穿刺活检病理明确诊断为ICC的患者资料。比较乙型肝炎相关ICC组（55例）和非乙型肝炎相关ICC组（107例）患者的一般资料及预后情况，并采用Cox比例风险回归模型分析影响ICC患者预后的独立因素。结果 乙型肝炎相关ICC组及非乙型肝炎相关ICC组患者的中位生存期分别为26、28个月，1、3、5年总生存率分别为80.0%、29.8%、14.5%和79.3%、31.2%、16.6%，1、3、5年无进展生存率分别为59.0%、21.5%、14.3%和52.6%、20.9%、13.1%，两组患者总生存率和无进展生存率差异均无统计学意义（P=0.487、0.634）。HBV-DNA水平分层分析显示，HBV-DNA≤50 IU/mL组和HBV-DNA>50 IU/mL组乙型肝炎相关ICC患者的总生存率、无进展生存率差异均无统计学意义（P=0.643、0.535）。多因素Cox比例风险回归分析显示，TNM分期Ⅳ期（HR=3.12，95% CI 1.57～6.20，P=0.001）、行根治性手术（HR=0.47，95% CI 0.26～0.87，P=0.016）、淋巴结转移（HR=2.10，95% CI 1.31～3.36，P=0.002）是ICC患者总生存的独立影响因素。结论 合并HBV感染对ICC患者预后无显著性影响。行根治性手术是ICC患者总生存的独立保护因素，TNM分期Ⅳ期和淋巴结转移是独立危险因素。 |
| 关键词: 乙型肝炎病毒 感染 肝内胆管细胞癌 预后 存活率分析 危险因素 |
| DOI：10.16781/j.0258-879x.2021.08.0846 |
| 投稿时间：2021-03-11修订日期：2021-06-28 |
| 基金项目:上海市卫生和计划生育委员会中医优势病种培育项目（ZYBZ-2017030）. |
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| Prognostic impact of hepatitis B virus infection on intrahepatic cholangiocarcinoma |
| MIAO Hui,GUO Chen-xu,WAN Qian-qian,SHI Liang-hui,WU Sheng-bing,WAN Xu-ying* |
(Department of Integrative Medicine, Eastern Hepatobiliary Surgery Hospital, Naval Medical University(Second Military Medical University), Shanghai 200438, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the impact of hepatitis B virus (HBV) infection on the prognosis of intrahepatic cholangiocarcinoma (ICC). Methods The data of 162 patients with ICC histologically proven by surgery or biopsy in Anting branch of our hospital from Oct. 2015 to Dec. 2019 were retrospectively analyzed. The general information and prognosis of patients with HBV-related ICC (55 cases) and non-HBV-related ICC (107 cases) were compared. Cox proportional hazard regression model was used to analyze the independent factors affecting the prognosis of ICC patients. Results The median survival time of patients in HBV-related ICC group and non-HBV-related ICC group were 26 and 28 months, and the 1-, 3- and 5-year overall survival rates were 80.0%, 29.8%, 14.5% and 79.3%, 31.2%, 16.6%, and the 1-, 3- and 5-year progression-free survival rates were 59.0%, 21.5%, 14.3% and 52.6%, 20.9%, 13.1%, respectively. There were no significant differences in overall survival rate or progression-free survival rate between the 2 groups (P=0.487, 0.634). Stratified analysis by HBV-DNA levels showed no significant difference in overall survival rate or progression-free survival rate between patients with HBV-related ICC in the HBV-DNA≤50 IU/mL group and HBV-DNA>50 IU/mL group (P=0.643, 0.535). Multivariate Cox proportional hazards regression analysis showed that TNM stage Ⅳ (hazard ratio [HR]=3.12, 95% confidence interval [CI] 1.57-6.20, P=0.001), radical surgery (HR=0.47, 95% CI 0.26-0.87, P=0.016) and lymph node metastasis (HR=2.10, 95% CI 1.31-3.36, P=0.002) were the independent influencing factors of overall survival in ICC patients. Conclusion HBV infection has no significant effect on the prognosis of ICC patients. Radical surgery is an independent protective factor for overall survival of ICC patients, and TNM stage Ⅳ and lymph node metastasis are the independent risk factors. |
| Key words: hepatitis B virus infection intrahepatic cholangiocarcinoma prognosis survival analysis risk factors |
