摘要
目的基于临床资料对接受肝移植的肝内与肝门部胆管癌受者进行研究,探讨其临床特点及肝移植预后相关危险因素。方法回顾性分析复旦大学附属华山医院普外科2014年6月25日至2018年10月31日收治的20例接受肝移植的肝内与肝门部胆管癌受者的临床资料,分析治疗及随访结果,采用KaPlan-Meier法计算存活率并绘制生存曲线,Cox回归模型分析受者预后影响因素。结果AJCC分期中Ⅰ、Ⅱ期受者累积复发率低于AJCC分期中Ⅲ、Ⅳ期的受者,差异有统计学意义;AJCC分期中Ⅰ、Ⅱ期受者累积复发率为0,而AJCC分期中Ⅲ、Ⅳ期的受者累积复发率为76%(P=0.042),Cox回归模型分析显示CA19-9是唯一影响预后的因素,高水平的CA19-9与移植术后的高复发率相关(HR=1.001;95%CI:1.000~1.001;P=0.035)。结论进展期胆管癌肝移植术后复发率较高,预后较差。CA19-9较高是肝内与肝门部胆管癌移植术后预后不良的独立危险因素。
Objective To explore the clinical features and risk factors associated with intrahepatic and hilar cholangiocarcinoma after liver transplantation.Methods Retrospective analysis of clinical data was performed for 20 hospitalized patients with intrahepatic and hilar cholangiocarcinoma from June 25,2014 to October 31,2018.Treatments and follow-up outcomes were analyzed.The survival rate was calculated by the Kaplan-Meier method and the survival curve plotted.Cox regression model was employed for analyzing the prognostic factors.Results The cumulative recurrence rate of patients with AJCC stageⅠ/Ⅱwas significantly lower than that in AJCC stageⅢ/Ⅳ.And the cumulative recurrence rate of stageⅠ/ⅡPatients was 0 and that of stageⅢ/Ⅳ76%(P=0.042).Cox regression model showed that CA19-9 was the only prognostic factor.An elevated level of CA19-9 was associated with high recurrence post-transplantation(HR=1.001;95%CI:1.000~1.001;P=0.035).Conclusions During progressive stage,the recurrence rate is higher with a worse prognosis.And an elevation of CA19-9 is an independent poor prognostic factor after intrahepatic and hilar cholangiocarcinoma transplantation.
作者
马恩斯
张全保
陶一峰
李瑞东
沈丛欢
马震宇
李建华
金嫣婷
王正昕
Ma Ensi;Zhang Quanbao;Tao Yifeng;Li Ruidong;Shen Conghuan;Ma Zhenyu;Li Jianhua;Jin Yanting;Wang Zhengxin(Department of General Surgery,Huashan Hospital,Fudan University,Shanghai 200041,China)
出处
《中华器官移植杂志》
CAS
北大核心
2019年第6期350-354,共5页
Chinese Journal of Organ Transplantation
基金
国家自然科学基金(81873874、81773089)
国家科技重大专项(2017ZX10203205-003-003、2017ZX10203205-002-004).
关键词
肝移植
胆管癌
复发
临床分期
Liver transplantation
Cholangiocarcinoma
Relapse
Clinical staging
