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目的总结伴神经浸润的肝门部胆管癌的临床病理类型、手术方式,探讨伴神经浸润的肝门部胆管癌治疗方法及远期存活率。方法对1993年1月至2004年12月收治的311例肝门部胆管癌(神经浸润组89例、无神经浸润组222例)的临床病理及随访资料进行回顾性分析。结果神经浸润是肝门部胆管癌的一种重要转移方式。伴神经浸润组的89例肝门部胆管癌的1、3、5年存活率分别为65.59%、22.71%、14.83%,无神经浸润组的222例肝门部胆管癌的1、3、5年存活率分别为80.62%、35.14%、24.98%,无神经浸润组存活率明显高于神经浸润组(P=0.037)。结论肿瘤的分化程度、手术方式是影响预后的重要因素。根治性切除是目前较理想的治疗方式。伴神经浸润的肝门部胆管癌患者的预后较差,远期疗效仍无显著改善,根治性切除术可望改善其预后。
Objective To summarize the clinicopathological types and surgical methods of hilar cholangiocarcinoma with infiltrating infiltration, and to explore the treatment and long-term survival rate of hilar cholangiocarcinoma with nerve infiltration. Methods The clinical data of 311 cases of hilar cholangiocarcinoma (89 cases of nerve infiltration group and 222 cases of no nerve infiltration group) admitted from January 1993 to December 2004 were analyzed retrospectively. Results Nerve infiltration is an important metastasis of hilar cholangiocarcinoma. The 1, 3, 5-year survival rates of 89 cases of hilar cholangiocarcinoma with nerve infiltration group were 65.59%, 22.71% and 14.83% respectively. There were 222 cases of hilar cholangiocarcinoma with no nerve infiltration group 1,3,5 The annual survival rates were 80.62%, 35.14% and 24.98%, respectively. The survival rate in the group without nerve invasion was significantly higher than that in the group with neural invasion (P = 0.037). Conclusion The degree of tumor differentiation and surgical approach are important factors that affect the prognosis. Radical resection is the ideal treatment. With poor prognosis of patients with hilar cholangiocarcinoma infiltration, the long-term efficacy still no significant improvement, radical resection is expected to improve its prognosis.