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目的探讨混合型肝细胞肝癌-胆管细胞癌(cHCC-CC)的治疗及影响其预后的因素。方法复习手术治疗cHCC-CC 25例的临床资料,分析影响其预后的因素。结果 25例患者的诊断均经手术切除标本病理证实。术后随访,14例获得再治疗。单因素分析显示,甲胎蛋白(AFP)水平、脉管内癌栓、淋巴结转移和肿瘤直径是影响累计生存率的重要因素。多因素分析显示,肿瘤直径和AFP是影响预后的独立危险因素。结论 cHCC-CC以手术治疗为主,但复发率高,预后差;采取多元化抗肿瘤治疗可提高术后生存期。
Objective To investigate the treatment of mixed hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC) and its prognostic factors. Methods The clinical data of 25 cases with cHCC-CC were retrospectively analyzed, and the factors influencing their prognosis were analyzed. Results The diagnosis of 25 patients was confirmed by pathological examination of the surgically resected specimens. After follow-up, 14 patients were re-treated. Univariate analysis showed that the level of AFP, intravascular thrombosis, lymph node metastasis and tumor diameter were the important factors affecting the cumulative survival rate. Multivariate analysis showed that tumor diameter and AFP were independent risk factors for prognosis. Conclusions The surgical treatment of cHCC-CC is the mainstay, but the recurrence rate is high and the prognosis is poor. Adopting diversified anti-tumor therapy can improve the postoperative survival.