The prognostic value of tumor budding in intrahepatic cholangiocarcinoma

中华普通外科杂志 Pub Date : 2019-12-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2019.12.012

Xiaopei Hao, Zeyuan Qiang, Kunfu Dai, Shuai Ma, Yuting He, L. Tao, Zhen Li, Mei-rong Xu, Haibo Yu

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Abstract

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 (0.785mm2). 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 Low-grade group was observed in 32 cases and high-grade group in 50. High-grade group appeared to develop tumors with higher CA199, poor differentiation, larger tumor diameter, advanced stage and high risks of lymphnode metastasis(respectively χ2=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 χ2=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=2.707 95% CI 1.558-4.705, P<0.001). Conclusions High-grade tumor budding is an important negative prognostic factor for ICC. Key words: Bile duct neoplasms; Prognosis

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肝内胆管癌肿瘤出芽的预后价值

目的探讨肿瘤出芽对肝内胆管癌根治术后预后的影响。方法回顾性分析2011年至2016年接受肝内胆管癌根治术患者的临床病理数据。在×200显微镜视野（0.785mm2）内计数肿瘤出芽数。根据受试者操作曲线（ROC），肿瘤出芽次数≥15为高级别组，<15为低级别组。对肿瘤的预测因素进行了多因素分析。结果低级别组32例，高级别组50例。高级别组出现CA199高、分化差、肿瘤直径大、晚期和淋巴结转移风险高的肿瘤（分别为χ2=5.470、4.359、5.101、4.696、5.960，均P<0.05），T分类和淋巴结转移与ICC患者的总生存率相关（χ2=11.704，4.876，5.056，5.152，8.442，16.725，均P<0.05），高级别组是OS恶化的重要独立预测因素（HR=2.70795%CI 1.558-4.705，P<0.001）。关键词：胆管肿瘤；预后

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中华普通外科杂志

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