| 摘要: |
| 目的 探讨影响肝内胆管癌术后患者生存的危险因素。方法 回顾性分析本院2009年3月至2014年3月收治的行根治性切除术的肝内胆管癌患者的临床资料,选择32种临床和实验室诊断检测相关指标,分析影响肝内胆管癌根治性切除患者术后生存危险因素,采用单因素、多因素Cox模型分析影响肝内胆管癌患者术后生存的危险因素。结果 最终入选患者189例,多因素分析表明,肿瘤数目、肿瘤大小、淋巴结转移情况、术前CA19-9水平、术前γ-谷氨酰转移酶、术后第1天血总胆红素及术后第5天血丙氨酸转氨酶是肝内胆管癌根治性切除患者术后生存的独立危险因素(P<0.05)。结论 术后第1天总胆红素及术后第5天丙氨酸转氨酶水平对肝内胆管癌根治性切除患者预后有指示作用;术前、术后积极保肝治疗,改善营养状况,术中尽量减少对肝脏的创伤,均有利于改善预后。 |
| 关键词: 胆管肿瘤 肝内胆管癌 根治性切除 预后 胆红素 丙氨酸转氨酶 |
| DOI：10.3724/SP.J.1008.2015.00627 |
| 投稿时间：2015-02-14修订日期：2015-06-08 |
| 基金项目:上海市卫生局重点项目(20134018). |
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| Prognostic value of liver function after radical excision in patients with intrahepatic cholangiocarcinoma |
| YU Yi1,ZHOU Fu-ping1,GUO Ling-ling1,CAO Yue1,ZHANG Qian1*,QIAN Qi-jun1,2* |
(1. Department of Biotherapy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China;
2. Laboratory of Viral and Gene Therapy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
*Corresponding authors) |
| Abstract: |
| Objective To analyze the prognostic factors influencing the survival of patients with intrahepatic cholangiocarcinoma (ICC) after radical excision. Methods The clinical data of ICC patients who were treated with radical excision from March 2009 to March 2014 in our hospital were retrospectively analyzed. A total of 32 clinical or laboratory findings were selected, and the risk factors influencing the survival of ICC patients after radical excision were analyzed by univariate analysis and Cox regression model. Results Ultimately 189 patients were included in this study. Multivariate analysis showed that tumor size, number of intrahepatic tumors, lymph node metastasis, pre-operation serum CA19-9 and γ-glutamyl transferase levels, one-day postoperative total bilirubin and five-day postoperative alanine aminotransferase levels were the independent prognostic factors for the survival of ICC patients after radical excision (P<0.05). Conclusion The one-day postoperative total bilirubin and five-day postoperative alanine aminotransferase may be used to predict the prognosis of ICC patient after radical resection. Preoperative and postoperative liver supporting treatment, minimizing liver trauma during operation, and improving the nutritional status can improve the prognosis of ICC patients. |
| Key words: bile duct neoplasms intrahepatic cholangiocarcinoma radical excision prognosis bilirubin alanine transaminase |
