摘要
分析55例肝外胆管癌的病理特点与预后关系。上段胆管癌24例(43.6%),中段胆管癌12例(21.8%),下段胆管癌19例(34.5%)。有42例得到病理诊断,大体形态属浸润型、结节型、乳头型分别为24、6、11例;镜下检查97.6%为腺癌,其中低分化占48.8%,中高分化51.2%。上段胆管癌以浸润型、低分化腺癌居多;下段胆管癌以乳头型、中高分化腺癌为主。淋巴结转移45.2%,肝转移25.5%。48例病人获得了随访,平均生存期10.8±9.7月(x±s)。胆管癌属上段、浸润型、低分化、伴淋巴结或肝转移者生存期明显缩短(P<0.01);但属下段、乳头型、中高分化、无淋巴结或肝转移者生存期延长。
To study the relationship between pathologic features and prognosis,55 cases extrahepatic cholangiocarcinoma from Jan. 1984 to Dec. 1993 were analyzed. Among the patients. 24 involved the upper third of extrahepatic biliary tract, 12,the middle third ,and 19 ,the lower third. Diagnosis of bile duct cancer was confirmed histopathologically in 42 patients ,with a predominace of adenocarcinoma including 24 infiltrative, 6 nodulur and 11 papillary type. The infiltrative,poorly-differentiated adenocarcinomas dominated in the upper third tumor,whereas the papillary and moderately-or-highly-differentiated adenocarcinomas preponderated in the lower third rumor. 45.2% had lymphatic metastasis and 21.5% had hepatic metastasis. 48 patients (87.7 %)had been followed-up. The overall mean survival period was 10.8±9.7 months (x±s ). The patients with cholangiocarcinomas of the upper third ,of infiltrative and poorly-differentiated types ,and with lympatie or hepatic metastasis had significantly shorter survival period than those with carcinomas of the lower third ,of papillary ,moderately-or highly differentiated type ,and without lymphatic or hepatic metastasis (P<0.01). Our data showed that the pathologic features of extrahepatic cholangiocarcinoma seemed to be closely associated with the patient's prognosis;early diagnosis of extrahepatic cholangiocarcinoma should be emphasized.
关键词
胆管肿瘤
病理学
预后
肝外胆管癌
Bile duct neoplasms extrahepatic
Pathology,clinical
Prognosis
