胆管癌预后因素分析.docVIP

胆管癌预后因素分析 作者：黄海,刘胜利 作者单位：1.南京中医药大学附属常州市中医院普外科， 江苏 常州 213001； 　2.南京东南大学附属中大医院肝胆外科， 江苏 南京210009 【摘要】 　　目的： 探讨影响胆管癌预后的危险因素。方法： 对62例胆管癌手术患者的临床资料进行回顾性研究。用Cox回归比例风险模型分析影响预后的危险因素。对每一指标行单因素分析，筛选出P0.1的自变量方可进入多因素分析。结果： 单因素分析显示影响预后的可能因素有5个，即ALP、ΓGGT、肿瘤分期、肿瘤分化程度、切缘癌细胞浸润情况。多因素分析显示显著影响预后的危险因素有3个，按影响大小依次是肿瘤分期、肿瘤分化程度、切缘癌细胞浸润情况。结论： 肿瘤分期早、分化程度高、获得切缘无癌细胞浸润的胆管癌患者预后好。加强早期诊断和获得根治性切除是改善胆管癌预后的关键。 【关键词】 胆管癌　 预后　危险因素 　　Analysis of factors of prognosis in cholangiocarcinoma 　　HUANG Hai， LIU Shengli 　　1.Department of General Surgery, Changzhou Traditional Chinese Medicine Hospital, the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Changzhou Jiangsu 213000; 　　2.Department of Hepatobiliary Surgery, Zhongda Hospital, the Affiliated Hospital of Southeast University, Nanjing Jiangsu 210009, China 　　［Abstract］ Objective: To investigate the risk factors which influenced the prognosis in cholangiocarcinoma. Methods： The clinical data of sixty two patients with cholangiocarcinoma after operation were reviewed retrospectively. Cox regression proportional hazard model was used in analysis of the risk factors influencing the prognosis. Before multivariate analysis, each parameter was evaluated with univariate analysis to define whether it was statistical significance (P0.1) or not. Then the parameters with statistical significance entered for further multivariate analysis. Results： Univariate analysis showed that the 5 factors might influence the prognosis including ALP, rGGT, tumour stage and differentiation grade, residual resection margin. Multivariate analysis presented that 3 factors influenced significantly prognosis, which in rank were tumour stage, tumour differentiation grade, residual resection margin. Conclusion： The prognosis was well in the patients with cholangiocarcinoma at early tumour stage, higher tumour differentiation grade and marginnegative residual resection. Acquired early diagnosis and radical