摘要
目的通过研究影响肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)淋巴结转移的临床病理因素,建立预测肝内胆管细胞癌淋巴结转移的模型。方法回顾性分析2000年1月至2015年1月在上海交通大学附属新华医院行手术治疗并淋巴结清扫或活检的84例ICC患者的临床病理资料。单因素和多因素logistic回归分析与淋巴结转移相关的危险因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线评价临床病理指标的预测价值。结果 84例患者中淋巴结转移的发生率为29.76%,单因素分析结果显示肿瘤数目、肿瘤分化程度、术前血清CA-199水平、血管侵犯以及术前CT显示淋巴结直径≥1 cm与淋巴结转移相关;进一步多因素分析显示,只有术前血清CA-199水平和术前CT显示淋巴结直径≥1cm与淋巴结转移相关。ROC曲线中,CA-199、术前CT以及CT联合CA-199的曲线下面积(area under the curve,AUC)分别为0.660、0.732和0.746。结论术前诊断ICC淋巴结转移仍然比较困难,CT联合CA-199对预测淋巴结转移的效能较单用CT高。
Objective The present study was conducted to explore the clinicopathological factors involved in lymph node metastasis( LNM) in patients with intrahapatic cholangiocarcinoma,and then creat a predictive model for LNM. Methods The clinicopathological factors of 84 patients with intrahepatic cholangiocarcinoma who underwent surgery including lymph node resection or biopsy between 2000 and 2015 in our institute were analyzed retrospectively. Univariate and multivariate analysis were performed to identify the risk factors for LNM. Receiver operating characteristic curve analysis was used to test the predicting value of the risk factors. Results The incidence rate of LNM was 29. 76% in our study,univariate analysis showed that multiple nodules,the pathological differentiation,the preoperative level of CA-199,vascular invasion and the diameter of lymph node ≥1cm on preoperative CT image were related to LNM,multivariate analysis showed that only preoperative level of CA-199 and preoperative CT image were risk factors. The area under the curve( AUV) of preoperative level of CA-199,preoperative CT image and preoperative CT image combined with serum CA-199 level were 0. 660,0. 732,0. 746 respectively. Conclusion It's difficult to diagnose LNM before operation for patients with intrahepatic cholangiocarcinoma,preoperative CT image combined with serum CA-199 level was better in predicting LNM than preoperative CT image only.
出处
《肝胆外科杂志》
2015年第5期349-352,共4页
Journal of Hepatobiliary Surgery
基金
国家科技重大专项课题"肝癌外科综合治疗的规范化
个体化和新策略研究"基金资助(2012ZX10002016)
关键词
肝内胆管细胞癌
淋巴结转移
CA-199
术前CT
intrahepatic cholangiocarcinoma
lymph node metastasis
CA-199
preoperative CT image
