Clinicopathological characteristics and prognoses of patients with combined hepatocellular carcinoma and cholangiocarcinoma

doi:10.3877/cma.j.issn.1674-0793.2011.06.002

Abstract

Abstract:

Objective

To explore the clinicopathologic characteristics of cHCC-CC and found out factors related to survival postoperation.

Methods

Forty-eight patients received surgery and were diagnosed with cHCC-CC pathologically from January 1992 to June 2010 in Cancer center of Sun Yat-sen University. Forty integral records of these patients were analyzed retrospectively.

Results

Tumor with multinodulars, vascular invasion, regional lymph nodes spreading or direct invasion of adjacent organs were present in 25%, 15%, 12.5%, 25% of cases respectively. Ten patients were found both HEP/AFP and CK18/19 positive and the prognosis was the worst. The overall survival rate at 1-, 3-, 5- years were 60.9%, 39.1% and 29.9% respectively. Recurrence were detected in 29 patients(72.5%) and most of them (79.3%) occur within the first year. Univariate analysis showed that poorly differentiated and positive of the vessel invasion were predictions of low overall survival (P < 0.05).

Conclusions

Patients with combined hepatocellular carcinoma and cholangiocarcinoma have poor postoperative survival rates. Poorly differentiated and positive of the vessel invasion wre associated with poorer survival.

Key words: Combined hepatocellular carcinoma and cholangiocarcinoma, Poorly differentiated, Hepatectomy, Prognoses

Jia-rui LIN, Rong-ping GUO, Wei WEI, Zhi-xing GUO. Clinicopathological characteristics and prognoses of patients with combined hepatocellular carcinoma and cholangiocarcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(06): 457-464.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2011.06.002

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2011/V05/I06/457

Figures/Tables 10

References 10

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项目	?	例数（百分比）	P值
肝炎感染*	HBsAg（+）	24（68.6）	0.311
?	HCVAb（+）	1（2.8）	?
?	无	10（28.6）	?
AFP（μ g/L）^#	< 25	20（51.3）	0.898
?	25～200	8（20.5）	?
?	>200	11（28.2）	?
CEA（μ g/L）^△	<5	28（77.8）	?
?	≥5	8（22.2）	0.672
CA 19-9（U/ml）^☆	< 37	17（48.6）	?
?	≥37	18（51.4）	0.537
肝硬化	有	19（47.5）	?
?	无	21（52.5）	0.358
肿瘤直径（cm）	<5	7（17.5）	?
?	≥5	33（82.5）	0.286
肿瘤位置	左外叶	6（15.0）	?
?	左内叶及右叶	34（85.0）	0.011
肿瘤数目（个）	1	22（55.0）	?
?	2～3	8（20.0）	0.016
?	≥4	10（25.0）	?
切缘（cm）	<1	23（57.5）	?
?	≥1	17（42.5）	?
肿瘤分化	中-高分化	30（75.0）	0.031
?	低分化	10（25.0）	?
肉眼血管癌栓	阳性	6（15.0）	0.003
?	阴性	34（85.0）	?
淋巴结转移	有（肝门部/其余部位）	5（3/2）（12.5）	0.000
?	无	35（87.5）	?
周围器官侵犯	有（胆囊/肝周其余器官）	10（2/8）（25.0）	0.066
?	无	30（75.0）	?
远处转移	有	2（5.0）	0.002
?	无	38（95.0）	?
TNM分期（2010）	Ⅰ	16（40.0）	?
?	Ⅱ	5（12.5）	?
?	Ⅲ	17（42.5）	0.001
?	Ⅳ	2（5.0）	（123A期与3BC4期比较）

项目	?	例数（百分比）	P值
肝炎感染*	HBsAg（+）	24（68.6）	0.311
?	HCVAb（+）	1（2.8）	?
?	无	10（28.6）	?
AFP（μ g/L）^#	< 25	20（51.3）	0.898
?	25～200	8（20.5）	?
?	>200	11（28.2）	?
CEA（μ g/L）^△	<5	28（77.8）	?
?	≥5	8（22.2）	0.672
CA 19-9（U/ml）^☆	< 37	17（48.6）	?
?	≥37	18（51.4）	0.537
肝硬化	有	19（47.5）	?
?	无	21（52.5）	0.358
肿瘤直径（cm）	<5	7（17.5）	?
?	≥5	33（82.5）	0.286
肿瘤位置	左外叶	6（15.0）	?
?	左内叶及右叶	34（85.0）	0.011
肿瘤数目（个）	1	22（55.0）	?
?	2～3	8（20.0）	0.016
?	≥4	10（25.0）	?
切缘（cm）	<1	23（57.5）	?
?	≥1	17（42.5）	?
肿瘤分化	中-高分化	30（75.0）	0.031
?	低分化	10（25.0）	?
肉眼血管癌栓	阳性	6（15.0）	0.003
?	阴性	34（85.0）	?
淋巴结转移	有（肝门部/其余部位）	5（3/2）（12.5）	0.000
?	无	35（87.5）	?
周围器官侵犯	有（胆囊/肝周其余器官）	10（2/8）（25.0）	0.066
?	无	30（75.0）	?
远处转移	有	2（5.0）	0.002
?	无	38（95.0）	?
TNM分期（2010）	Ⅰ	16（40.0）	?
?	Ⅱ	5（12.5）	?
?	Ⅲ	17（42.5）	0.001
?	Ⅳ	2（5.0）	（123A期与3BC4期比较）

参数	P值	HR	95%CI
病理学分类（低分化/高分化）	0.027	3.459	1.148-10.421
位置（左外叶/非左外叶）	0.120	0.337	0.086-1.329
切缘，cm（< 1/≥1）	0.463	0.604	0.157-2.323
卫星子灶（阳性/阴性）	0.611	0.679	0.153-3.015
脉管侵犯（阳性/阴性）	0.003	8.493	2.090-34.524
周围器官侵犯（阳性/阴性）	0.307	2.855	0.381-21.385
TNM分期（ⅠⅡⅢA/ⅢBCⅣ）	0.137	2.208	0.778-6.265

参数	P值	HR	95%CI
病理学分类（低分化/高分化）	0.027	3.459	1.148-10.421
位置（左外叶/非左外叶）	0.120	0.337	0.086-1.329
切缘，cm（< 1/≥1）	0.463	0.604	0.157-2.323
卫星子灶（阳性/阴性）	0.611	0.679	0.153-3.015
脉管侵犯（阳性/阴性）	0.003	8.493	2.090-34.524
周围器官侵犯（阳性/阴性）	0.307	2.855	0.381-21.385
TNM分期（ⅠⅡⅢA/ⅢBCⅣ）	0.137	2.208	0.778-6.265

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