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目的 探讨影响胆管癌切除术后的预后因素。方法 对 1980～ 1995年 86例胆管癌切除术后患者进行研究。选择 15个可能对胆管癌切除术后预后产生影响的非重复性特征性临床因素 ,通过Cox比例风险模型对胆管癌切除术后患者预后进行多因素分析。结果 全组 1年生存率为72 6 % ,3年生存率为 32 .4% ,5年生存率为 18.7%。单因素分析得出肿瘤的组织学类型 淋巴结转移 胰腺浸润 十二指肠浸润 神经浸润 周围血管浸润 切缘癌残留和浸润深度对预后有影响(P 0 0 5 )。Cox模型多因素分析结果表明 ,胰腺浸润 神经浸润和淋巴结转移是影响预后的主要因素。结论 胰腺浸润 神经浸润和淋巴结转移状况是胆管癌切除术后影响预后的最重要因素。
Objective To investigate the prognostic factors after cholangiocarcinoma resection. Methods Eighty-six patients with cholangiocarcinoma from 1980 to 1995 were studied. Fifteen non-repetitive characteristic clinical factors that may affect prognosis after cholangiocarcinoma resection were selected. Multivariate analysis was performed on the prognosis of cholangiocarcinoma patients by Cox proportional hazards model. Results The overall 1-year survival rate was 72.6%, the 3-year survival rate was 32.4%, and the 5-year survival rate was 18.7%. Univariate analysis showed that the histological type of lymph node metastasis of pancreatic invasion of pancreatic duodenal infiltration around the infiltration of peripheral vascular invasion margin cancer depth and depth of invasion have an impact on prognosis (P 0 0 5). Cox model multivariate analysis showed that infiltration of pancreatic infiltration and lymph node metastasis is the main factor affecting the prognosis. Conclusions The infiltration of pancreatic nerve and the status of lymph node metastasis are the most important factors affecting prognosis after cholangiocarcinoma resection.