摘要
目的探讨肿瘤出芽在肝内胆管细胞癌根治术后的预后评估价值。方法回顾性分析2011―2016年因肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)行根治性切除术患者的临床病理资料,用病理切片计数出芽,采用接受者运行曲线(ROC)定义肿瘤出芽个数< 15为肿瘤出芽低级别组,≥15为肿瘤出芽高级别组。分析出芽对预后的影响。结果82例ICC患者,肿瘤出芽低级别组32例,高级别组50例。髙级别组血清CA199水平高、分化差、肿瘤直径大、T分期高、淋巴结转移风险高(分别X^2=5.470,4.359,5.101,4.696,5.960,均P<0.05);单因素分析显示,高级别出芽、CA199、分化程度、肿瘤直径、T分期、淋巴结转移与ICC患者的总生存期有关(分别x^2=11.704,4.876,5.056,5.152,8.442,16.725,均P<0.05);多因素回归分析结果显示,高级别出芽是ICC术后预后不良的独立影响因素(HR=2.70795% CI 1.558-4.705,P<0.001)。结论高级别肿瘤出芽是ICC根治性切除术后预后不良的重要因素。
Objective To evaluate the role of tumor budding in the prognostic value of intrahepatic cholangiocarcinoma(ICC)after radical resection.Methods The clinicopathological data of patients undergoing radical resection for intrahepatic cholangiocarcinoma between 2011 and 2016 were retrospectively analyzed.The number of tumor budding was counted in a × 200 microscopic field(0.785mm^2).Based on receiver operation curve(ROC),the number of tumor budding≥15 was defined as high-grade group,and<15 was low-grade group.Multivariate analysis were performed on predictors of the tumor.Results Lowgrade group was observed in 32 cases and high-grade group in 50.High-grade group appeared to develop tumors with higher CAI99,poor differentiation,larger tumor diameter,advanced stage and high risks of lymphnode metastasis(respectively X^2=5.470,4.359,5.101,4.696,5.960,all P<0.05).Univariate analysis showed that tumor budding,CA199,differentiation,tumor diameter,T classification and lymphnode metastasis were related to the overall survival of patients with ICC(respectively X^2=11.704,4.876,5.056,5.152,8.442,16.725,all P<0.05).On multivariable analysis,high-grade group was a significant independent predictor of worse OS(HR=2.70795% CI 1.558-4.705,P<0.001).Conclusions High-grade tumor budding is an important negative prognostic factor for ICC.
作者
郝晓沛
强泽远
代坤甫
马帅
何雨婷
陶连元
李珍
徐梅
余海波
Hao Xiaopei;Qiang Zeyuan;Dai Kurifu;Ma Shuai;He Yuting;Tao Lianyuan;Li Zhen;Xu Mei;Yu Haibo(Department of Hepatobiliary Surgery of People,s Hospital,Zhengzhou University(Henan Provincial Peoplefs Hospital),Zhengzhou 450003,China;Department of Pathology of People's Hospital,Zhengzhou University(Henan Provincial People's Hospital),Zhengzhou 450003,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2019年第12期1060-1063,共4页
Chinese Journal of General Surgery
基金
河南省重点科技攻关计划项目(132102310385)
河南省医学科技攻关计划重点项目(201502018)
河南省重点科技攻关计划项目(132102310096)。
关键词
胆管肿瘤
预后
Bile duct neoplasms
Prognosis
