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143例原发性胆囊癌外科诊疗及预后影响因素分析
Surgical Diagnosis and Treatment of Gallbladder Carcinoma and Factors Influencing Prognosis: A Report of 143 Cases
【作者】 耿诚；
【导师】 温浩；
【作者基本信息】 新疆医科大学 ， 外科学， 2010， 硕士
【摘要】 目的:研究原发性胆囊癌临床特征,分析探讨影响预后有关因素以指导原发性胆囊癌治疗。方法:回顾性分析2002年1月～2008年12月间就诊于我院143例胆囊癌患者的临床、病理资料,并采用Kaplan-Meier模型、Log-rank检验及COX比例风险模型进行统计学分析。结果:143例中76例患者行手术治疗,非手术治疗以及放弃治疗者67例。获得随访123例(86%),AJCCI期与II期患预后远好于AJCCIII期与IV期患者。多因素分析显示:是否存在梗阻性黄疸症状,肿瘤AJCC分期及治疗方式与胆囊癌预后显著相关。结论:胆囊癌患者尽可能施行根治性手术,多种检查方法相结合以高早期诊断率,两者均为提高胆囊癌患者预后的关键措施。
【Abstract】 Objective: To investigate the clinical characteristics of primary carcinoma of the gallbladder (PCG) and discuss factors affecting prognosis for guiding treatment of PCG. Methods: A retrospective clinical analysis was made in 143 cases of PCG admitted in our hosptial from January 2002 to December 2008. The data were processed with statistical methods including Kaplan-Meier model, Log-rank test in univariate analyses and COX regression model in multivariate analyses. Results: 76 cases were followed up, AJCC I and II have a much better prognosis than, AJCC III and IV. Multivariate analysis revealed that the symptom of obstructive jaundice, AJCC stage and therapeutic interventions significantly affected prognosis of PCG. Conclusions: Radical resection should be selected for cases with PCG as possible; combined examination methods can improve accuracy of early diagnosis, both of which are key measures for facilitating prognosis of cases with PCG.