摘要
目的 分析 B超、CT等方法对肝门部胆管癌的诊断价值 ,探讨肝门部胆管癌早期诊断方法及病理类型与患者生存期的关系。方法 根据病情术前对 48例肝门部胆管癌分别经 B超、CT、经内窥镜逆行性胰胆管造影、经皮肝穿刺胆道造影等方法进行探查 ,并结合肝功能、血清癌胚抗原等检查 ,评估肿瘤的生长状况。根据肿瘤的部位和浸润转移的情况 ,分别采用根治性手术、姑息性手术和非手术治疗。手术标本皆经病理学检查。结果 1B超对肝门部胆管癌诊断的准确率达 93.8%。2肝门部胆管癌中 ,低分化腺癌及粘液腺癌所占的比例较高 ,为 6 5 .8% (2 5 /38)。3低分化腺癌发生肝转移和周围淋巴结、神经及血管浸润转移率明显高于高分化腺癌 ,平均生存期较高分化腺癌短。 4手术切除率为 36 .8% ,高分化腺癌切除组患者的生存期高于非手术治疗组。结论 B超对肝门部胆管癌的诊断有较高的价值 ,肝门部胆管癌病理类型与预后明显相关。
Objective Study the early diagnosis of portal hepatic cholangiocarcinoma and study the correlation of path ological type with the life span of these patients.Methods After hospitalization Patients come through by Bus,CT,ERCP,PTC&ERCP and so on,assessment the state of growth of tumor by the help of check hepatic function,Serum carcinoembryonic antigen.According to the site and infiltrate state of tumor,we accord patient with radical surgical,appeasement surgical and non surgical treatment.All specimens must go through by pathematology examination as common practice.Results ①Correct rate of diagnosis of portal cholangiocarcinoma by Bus is 93 8% .②The proportion of poor differentiation adenocarcinoma and mucinous adenocarcinoma is comparatively higher( 65 8% ) in this study.③Poor differentiation adenocarcinoma is easy to transfer to the liver,periphery lymph nodes,nerve and blood vessel of hilum,and the average life span of it is shorter than well differentiation types.④The resection rate of our group is 36 8% ,the average life span of patients after surgery is longer than nonsurgical group.Conclusion Bus have high diadynamic value in the diagnosis of portal cholangiocarcinoma,the prognosis of it is close connect with the pathological type.Except tumor widespread to the both lobes of the liver and infiltrate over both segment duct,proper hepatic artery or both hepatic artery and the trunk of portal vein,We figure should give a surgical treatment to the patient,the curative effect of it is better than non surgical treatment group.
出处
《华中医学杂志》
CAS
2000年第1期6-7,共2页
Central China Medical Journal
关键词
肝门部
胆管癌
B超
早期诊断
CT
Portal cholangiocarcinoma Type B ultrasound Pathologic type Surgical treatment
