Clinical characteristics and prognosis of 26 cases of combined hepatocellular carcinoma and cholangiocarcinoma

中华普通外科杂志 Pub Date : 2020-02-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2020.02.011

Linhong Wu, Peng-ji Gao, Jie Gao, Zhao Li, Jiye Zhu, X. Leng

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Abstract

Objective To investigate the clinical manifestations, imaging features and prognosis of mixed liver cancer. Methods The clinical and pathological data of 26 patients with combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) pathologically diagnosed after liver resection were retrospectively analyzed, and the relevant factors affecting the prognosis were statistically analyzed. Results Of the 26 cHCC-CC patients, 19 were on background of chronic viral hepatitis, including 17 chronic viral hepatitis B and 2 chronic viral hepatitis C. There were 18 cases having AFP≥20ng/ml, 9 cases were with carbohydrate antigen 199 (CA199)≥37U/ml, and 5 cases with carcinoembryonic antigen (CEA)≥5ng/ml. The 1 -, 3 -, and 5-year postoperative survival rates were 68.8%, 34.4%, and 17.4%. Multivariate analysis showed that serum CA199≥37U/ ml(χ2=5.687, P=0.019) was an independent risk factor for patients′ survival. Conclusion Most cHCC-CC is found in association with chronic viral hepatitis. Serum CA199≥37U/ml is an independent risk factor affecting patients survival. Key words: Carcinoma, hepatocellular; Prognosis; Survival analysis

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肝细胞癌合并胆管癌26例临床特点及预后分析

目的探讨混合性肝癌的临床表现、影像学特征及预后。方法回顾性分析26例肝切除术后病理诊断为肝细胞癌合并胆管癌(cHCC-CC)患者的临床及病理资料，并对影响预后的相关因素进行统计分析。结果26例cHCC-CC患者中，慢性病毒性肝炎背景19例，其中慢性乙型肝炎17例，慢性丙型肝炎2例，AFP≥20ng/ml 18例，碳水化合物抗原199 (CA199)≥37U/ml 9例，癌胚抗原(CEA)≥5ng/ml 5例。术后1、3、5年生存率分别为68.8%、34.4%、17.4%。多因素分析显示，血清CA199≥37U/ ml(χ2=5.687, P=0.019)是影响患者生存的独立危险因素。结论cHCC-CC多与慢性病毒性肝炎相关。血清CA199≥37U/ml是影响患者生存的独立危险因素。关键词:肝癌;肝细胞癌;预后;生存分析

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中华普通外科杂志

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