乙型肝炎病毒感染肝内胆管癌病例临床病理特点.docVIP

乙型肝炎病毒感染的肝内胆管癌病例的临床病理特点 乙型肝炎病毒感染的肝内胆管癌病例的临床病理特点 作者：陶连元，何小东，曲强，蔡磊，刘卫，武峤 作者单位：中国医学科学院北京协和医学院，北京协和医院 基本外科，北京 100730 北京市重点学科资助项目(HK100230446) 【摘要】 目的 探索乙型肝炎病毒（hepatitis B virus，HBV）感染与肝内胆管癌（intrahepatic cholangiocarcinoma，ICC）临床病理变化之间的联系。方法 统计59例经病理确诊的ICC患者，分为3组：组Ⅰ，HBsAg(+)（乙肝表面抗原）/anti-HBc(+)（乙肝核心抗体）(n=16)；组Ⅱ，HBsAg(-)/anti-HBc(+)(n=30)；组Ⅲ，HBsAg(-)/anti-HBc(-)(n=13)，分析和比较其临床病理特点。结果 组Ⅰ的发病平均年龄(P=0.025)和CA19-9的阳性率(25 U/ml)(P=0.025)比组Ⅲ低，但组Ⅰ的PT均值(P=0.031)，肝硬化(P=0.044)和体质量减轻(P=0.044)高于组Ⅲ。组Ⅰ癌变易发于右肝，而组Ⅲ易发于左肝(P=0.0032)，并且组Ⅰ患者的预后比组Ⅱ和组Ⅲ好(P=0.013)。结论 HBV感染的ICC患者肿瘤发病年龄较早，更容易出现CA19-9阴性和肝硬化，PT平均值高，并且易出现体质量减轻和发生肝右叶ICC，但其预后相对较好。 【关键词】 肝内胆管肿瘤；病毒，乙型肝炎；临床病理；预后 Clinicopathologic characteristics of intrahepatic cholangiocarcinoma patients with hepatitis B virus infection TAO Lianyuan， HE Xiaodong， QU Qiang， et al. Department of Basic Surgery， Peking Union Medical College Hospital (PUMCH)， Chinese Academy of Medical Sciences (CAMS) Peking Union Medical College (PUMC)， Beijing 100730 　　Abstract Objective To clarify the relationship among hepatitis B virus (HBV) infection， the clinicopathologic change and prognosis of intrahepatic cholangiocarcinoma (ICC) patients. Methods Data of fifty-nine patients whose ICC was confirmed pathologically were collected and divided into three groups： group Ⅰ， HBsAg (hepatitis B virus surface antigen)-positive， anti-HBc (Hepatitis B core antibody)-positive (n=16)； group Ⅱ， HBsAg-negative， anti-HBc-positive (n=30)； group Ⅲ， HBsAg-negative， anti-HBc-negative (n=13)； whose clinicopathologic features were analyzed and compared. Results The mean age of group Ⅰ (P=0.025) and the positive rate of CA19-9 (25 U/ml) (P=0.025) were lower than that of group Ⅲ， but the mean PT value (P=0.031)， the frequency of hepatic cirrhosis (P=0.044) and weight loss (P=0.044) in group Ⅰ were higher than those of group Ⅲ. In addition， cancerization of ICC patients in the group Ⅰ easily occurred in the right liver， and the cancerization in the gr