肝周胆管癌肝边缘的现状:一项多中心研究

IF 7.5 1区 医学 Q1 SURGERY
Shuo Jin,Ming-Yu Lin,Can-Hong Xiang,Zhi-Peng Liu,Si-Yuan Wang,Nan Jiang,Li Li,Si-Qiao Shan,Jian-Ping Zeng,Hai-Xin Yin,Tao Zhang,Chang-Zhen Yang,Dong-Liang Yang,Hu Zhou,Zhi-Yu Chen,Jia-Hong Dong
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引用次数: 0

摘要

目的本研究旨在调查切除的肝周胆管癌(pCCA)肝边缘(LM)癌变的发生率和分布情况,并建立LM检查方法。背景LM是切除的pCCA中最大的边缘,其状态和评估方法尚未明确。结果发现队列的 LM R1 切除率为 38.6%(39/101),对照队列为 5.6%(7/126)。在发现队列中,与小切片相比,WDLS发现了更多的LM R1病例(38.6% vs. 5.9%,P<0.001)。发现队列中的 R0 患者的总生存期和无复发生存期均优于对照队列(P<0.05)。此外,95%的癌细胞位于近端导管边缘(DM)20 毫米范围内。近端DM距离小于5毫米是LM R1切除的独立风险因素。结论LM阳性是导致pCCA R1切除的重要原因,使用WDLS提高了LM诊断的准确性。该研究建立了一套检查方法,强调必须检查近端 DM 周围 20 毫米半径内的 LM,尤其是近端 DM 小于 5 毫米的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Status of Liver Margin in Perihilar Cholangiocarcinoma: A Multicenter Study.
OBJECTIVE This study aimed to investigate the prevalence and distribution of carcinoma in the liver margin (LM) of resected perihilar cholangiocarcinoma (pCCA) and establish a method for LM examination. BACKGROUND LM is the largest margin in resected pCCA with undefined status and assessment method. METHODS 227 pCCA cases underwent major hepatectomy were divided into a discovery cohort (n=101) assessed using serial whole-mount digital large sections (WDLS) combined with small sections, and a control cohort (n=126) assessed using only small sections. RESULTS The LM R1 resection rate was 38.6% (39/101) in the discovery cohort and 5.6% (7/126) in the control cohort. WDLS identified more LM R1 cases compared to the small section in the discovery cohort (38.6% vs. 5.9%, P<0.001). R0 patients in the discovery cohort had better overall survival and recurrence-free survival than those in the control cohort (both P<0.05). Additionally, 95% of carcinoma was found within 20 mm of the proximal ductal margin (DM). A proximal DM distance of<5 mm was an independent risk factor for LM R1 resection. Patients with which are more likely to experience R1 compared to those with ≥ 5 mm (P<0.001). CONCLUSIONS Positive LM was the significant cause for R1 resection of pCCA and the utilization of WDLS improved the diagnostic accuracy of LM. An examination methodology was established, highlighting the necessity of examining LM within a 20 mm radius around the proximal DM, especially in patients with a proximal DM of<5 mm.
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来源期刊
Annals of surgery
Annals of surgery 医学-外科
CiteScore
14.40
自引率
4.40%
发文量
687
审稿时长
4 months
期刊介绍: The Annals of Surgery is a renowned surgery journal, recognized globally for its extensive scholarly references. It serves as a valuable resource for the international medical community by disseminating knowledge regarding important developments in surgical science and practice. Surgeons regularly turn to the Annals of Surgery to stay updated on innovative practices and techniques. The journal also offers special editorial features such as "Advances in Surgical Technique," offering timely coverage of ongoing clinical issues. Additionally, the journal publishes monthly review articles that address the latest concerns in surgical practice.
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