Journal of Surgery Concepts & Practice ›› 2022, Vol. 27 ›› Issue (03): 221-228.doi: 10.16139/j.1007-9610.2022.03.008
• Original article • Previous Articles Next Articles
YIN Yanjiang, LUO Zhiwen, CHEN Xiao, ZHANG Yefan, HUANG Zhen, ZHAO Hong, ZHAO Jianjun, LI Zhiyu, ZHOU Jianguo, CAI Jianqiang, BI Xinyu()
Received:
2021-03-09
Online:
2022-06-25
Published:
2022-08-03
Contact:
BI Xinyu
E-mail:beexy1971@163.com
CLC Number:
YIN Yanjiang, LUO Zhiwen, CHEN Xiao, ZHANG Yefan, HUANG Zhen, ZHAO Hong, ZHAO Jianjun, LI Zhiyu, ZHOU Jianguo, CAI Jianqiang, BI Xinyu. Relationship between surgical margin and prognosis of patients with intrahepatic cholangiocarcinoma[J]. Journal of Surgery Concepts & Practice, 2022, 27(03): 221-228.
临床病理因素 | 病例数 | 临床病理因素 | 病例数 |
---|---|---|---|
年龄 | 57.8±9.2 | 淋巴结清扫数 | 4 |
性别 | 阳性淋巴结数 | 1 | |
男 | 40(56.3%) | 肿瘤最大径(cm) | 5.5±2.2 |
女 | 31(43.7%) | >5 | 35(49.3%) |
肝炎史 | ≤5 | 36(50.7%) | |
无 | 54(76.1%) | LCSGJa)分期 | |
乙型肝炎 | 16(22.5%) | Ⅰ | 31(43.7%) |
丙型肝炎 | 1(1.4%) | Ⅱ | 19(26.8%) |
肝硬化史 | 12(16.9%) | Ⅲ | 6(8.5%) |
胆系疾病史 | Ⅳ | 15(21.1%) | |
胆结石 | 8(11.3%) | 手术切缘状态 | |
胆囊炎 | 7(9.9%) | R0 | 59(83.1%) |
无 | 56(78.9%) | R1 | 12(16.9%) |
肿瘤数目 | 切缘距离(cm) | 0.4 | |
单发 | 66(93.0%) | 术中出血量(mL) | 200 |
多发 | 5(7.0%) | 术中输血 | 45(63.4%) |
分化程度 | 术中输液量(mL) | 2 200 | |
低 | 37(52.1%) | 手术时间(h) | 3.7±1.3 |
中 | 32(45.1%) | 术后发生并发症 | 4(5.6%) |
高 | 2(2.8%) | 术后住院时间(d) | 9 |
血管侵犯 | 27(38.0%) | CA19-9(U/mL) | 130 |
其他器官侵犯 | 6(8.5%) | ALT(U/L) | 28 |
T | AST(U/L) | 24 | |
T1 | 34(47.9%) | GGT(U/L) | 54 |
T2 | 20(28.2%) | AFP(μg/L) | 2.96 |
T3 | 10(14.1%) | CEA(μg/L) | 2.56 |
T4 | 7(9.9%) | TBIL(μmol/L) | 11.3 |
N | ALB(g/L) | 47.1±9.5 | |
N0 | 59(83.1%) | PT(s) | 12.1±1.7 |
N1 | 12(16.9%) | 腹腔积液 | |
AJCC分期 | 无 | 65(91.5%) | |
Ⅰ | 31(43.7%) | 少量 | 5(7.0%) |
Ⅱ | 19(26.8%) | 多量 | 1(1.4%) |
Ⅲ | 19(26.8%) | Child-Pugh分级 | |
Ⅳ | 2(2.8%) | A | 66(93.0%) |
淋巴结清扫 | 45(63.4%) | B | 5(7.0%) |
变量 | OS期(月) | RFS期(月) | |||||
---|---|---|---|---|---|---|---|
P值 | HR | 95%CI | P值 | HR | 95%CI | ||
性别 | 0.872 | 0.953 | (0.533, 1.706) | 0.604 | 0.871 | (0.518, 1.466) | |
就诊年龄 | 0.892 | 0.998 | (0.968, 1.029) | 0.957 | 1.001 | (0.974, 1.028) | |
肝炎史 | 0.718 | 0.882 | (0.448, 1.739) | 0.952 | 1.019 | (0.563, 1.841) | |
肝硬化 | 0.579 | 0.796 | (0.355, 1.782) | 0.799 | 0.915 | (0.461, 1.817) | |
胆系疾病 | 0.629 | 0.828 | (0.386, 1.777) | 0.598 | 0.837 | (0.432, 1.621) | |
肿瘤数目 | 0.017a) | 1.980 | (1.701, 2.591) | 0.005a) | 1.424 | (0.510, 3.981) | |
分化程度 | |||||||
低 | |||||||
中 | 0.572 | 0.844 | (0.468, 1.521) | 0.413 | 0.801 | (0.471, 1.363) | |
高 | 0.794 | 0.766 | (0.104, 5.671) | 0.307 | 2.145 | (0.496, 9.284) | |
肿瘤最大径 | 0.039a) | 1.113 | (1.014, 1.256) | 0.322 | 1.058 | (0.947, 1.182) | |
其他器官侵犯 | 0.028a) | 2.962 | (1.127, 7.788) | 0.307 | 1.630 | (0.639, 4.162) | |
淋巴结转移 | 0.007a) | 2.776 | (1.330, 5.792) | 0.002a) | 3.129 | (1.525, 6.422) | |
LCSGJ分期 | |||||||
Ⅰ | |||||||
Ⅱ | 0.784 | 1.111 | (0.524, 2.335) | 0.147 | 0.610 | (0.313, 1.190) | |
Ⅲ | 0.202 | 1.946 | (0.700, 5.406) | 0.939 | 1.038 | (0.397, 2.716) | |
ⅣA、ⅣB | 0.056 | 3.073 | (1.434, 6.582) | 0.054 | 1.945 | (0.988, 3.829) | |
AJCC分期 | |||||||
ⅠA、ⅠB | |||||||
Ⅱ | 0.783 | 1.111 | (0.524, 2.356) | 0.146 | 0.609 | (0.313, 1.188) | |
ⅢA、ⅢB | 0.008a) | 2.600 | (1.277, 5.291) | 0.207 | 1.490 | (0.802, 2.769) | |
Ⅳ | 0.207 | 3.752 | (0.480, 9.296) | 0.008a) | 2.929 | (2.233, 5.323) | |
血管侵犯 | 0.874 | 0.953 | (0.526, 1.725) | 0.038a) | 1.657 | (1.377, 2.144) | |
手术切缘状态 | 0.008a) | 2.439 | (1.267, 4.696) | 0.011a) | 1.539 | (1.188, 1.894) | |
ALT | 0.689 | 1.001 | (0.997, 1.004) | 0.987 | 1.000 | (0.996, 1.003) | |
AST | 0.925 | 1.000 | (0.993, 1.007) | 0.797 | 0.999 | (0.993, 1.005) | |
GGT | 0.273 | 1.001 | (0.999, 1.003) | 0.046a) | 1.002 | (1.000, 1.003) | |
AFP | 0.010a) | 1.007 | (1.002, 1.013) | 0.021a) | 1.006 | (1.001, 1.010) | |
CEA | 0.045a) | 1.005 | (1.000, 1.011) | 0.380 | 1.002 | (0.997, 1.007) | |
TBIL | 0.243 | 1.003 | (0.998, 1.009) | 0.154 | 1.004 | (0.999, 1.009) | |
ALB | 0.728 | 1.005 | (0.976, 1.036) | 0.763 | 0.996 | (0.968, 1.024) | |
PT | 0.424 | 1.067 | (0.911, 1.249) | 0.108 | 1.123 | (0.975, 1.295) | |
CA19-9 | 0.004a) | 1.768 | (1.198, 2.740) | 0.022a) | 3.377 | (1.507, 5.162) | |
腹腔积液 | |||||||
无 | |||||||
少量 | 0.278 | 0.456 | (0.110, 1.887) | 0.119 | 0.324 | (0.079, 1.337) | |
多量 | 0.953 | 0.942 | (0.129, 6.872) | 0.611 | 0.598 | (0.082, 4.352) | |
Child-Pugh分级 | |||||||
A | |||||||
B | 0.328 | 1.595 | (0.626, 4.065) | 0.555 | 1.321 | (0.525, 3.323) |
变量 | OS期(月) | RFS期(月) | |||||
---|---|---|---|---|---|---|---|
P值 | HR | 95%CI | P值 | HR | 95%CI | ||
肿瘤数目 | 0.123 | 2.463 | (0.783, 7.749) | 0.329 | 1.806 | (0.551, 5.915) | |
肿瘤最大直径 | 0.371 | 1.077 | (0.919, 1.255) | ||||
其他器官侵犯 | 0.183 | 2.447 | (0.656, 9.135) | ||||
淋巴结转移 | 0.474 | 1.514 | (0.487, 4.708) | 0.402 | 1.631 | (0.520, 5.114) | |
AJCC分期 | |||||||
ⅠA、ⅠB | |||||||
Ⅱ | 0.876 | 0.935 | (0.405, 2.158) | 0.686 | 0.811 | (0.293, 2.244) | |
ⅢA、ⅢB | 0.443 | 1.537 | (0.513, 4.608) | 0.386 | 1.643 | (0.535, 5.040) | |
Ⅳ | 0.573 | 1.990 | (0.182, 2.779) | 0.026a) | 2.376 | (1.486, 3.375) | |
血管侵犯 | 0.242 | 0.586 | (0.239, 1.434) | ||||
手术切缘状态 | 0.041a) | 1.946 | (1.438, 2.464) | 0.044a) | 1.582 | (1.011, 2.474) | |
GGT | 0.301 | 1.001 | (0.999, 1.003) | ||||
AFP | 0.001a) | 1.010 | (1.004, 1.016) | 0.017a) | 1.006 | (1.001, 1.011) | |
CEA | 0.847 | 0.999 | (0.991, 1.007) | ||||
CA19-9 | 0.027a) | 2.310 | (1.263, 3.167) | 0.181 | 1.539 | (0.818, 2.894) |
变量 | R0切缘(n=59) | R1切缘(n=12) | P值 |
---|---|---|---|
年龄(岁) | 57.81 | 57.83 | >0.05 |
肝炎史[n(%)] | 43(73) | 11(92) | >0.05 |
肝硬化史[n(%)] | 48(81) | 11(92) | >0.05 |
胆系疾病史[n(%)] | 47(80) | 10(83) | >0.05 |
肿瘤数目(单发/多发)[n(%)] | 57(97)/2(3) | 10(83)/2(17) | <0.05a) |
分化程度(低/中、高)[n(%)] | 29(49)/30(51) | 8(67)/4(33) | >0.05 |
血管侵犯[n(%)] | 37(63) | 7(58) | >0.05 |
其他器官侵犯[n(%)] | 55(93) | 10(83) | >0.05 |
肿瘤最大径(cm) | 4.31 | 6.15 | >0.05 |
AJCC分期(Ⅰ、Ⅱ/Ⅲ、Ⅳ)[n(%)] | 45(76)/14(24) | 5(42)/7(58) | <0.05a) |
LCSGJ分期(Ⅰ、Ⅱ/Ⅲ、Ⅳ)[n(%)] | 45(76)/14(24) | 5(42)/7(58) | <0.05a) |
CA19-9(U/mL) | 85.42 | 164.9 | >0.05 |
ALT(U/L) | 62.95 | 84.75 | >0.05 |
AST(U/L) | 39 | 52.67 | >0.05 |
GGT(U/L) | 99.53 | 112.5 | >0.05 |
AFP(μg/L) | 12.56 | 11.43 | >0.05 |
CEA(μg/L) | 11.18 | 31.15 | >0.05 |
TBIL(μmol/L) | 19.62 | 19.93 | >0.05 |
ALB(g/L) | 45.55 | 44.34 | >0.05 |
PT(s) | 12.09 | 12.3 | >0.05 |
腹腔积液[n(%)] | 54(92) | 11(92) | >0.05 |
Child-Pugh分级(A/B)[n(%)] | 55(93)/4(7) | 11(92)/1(8) | >0.05 |
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