田雾;丁海华;于洋;孙红成;
TIAN Wu;DING Haihua;YU Yang;SUN Hongcheng;Department of General Surgery,Orthopaedics Hospital of Guizhou Province;Department of General Surgery,Integrated Chinese and Western Medicine Hospital of Zhenjiang City;Department of Hepatobiliary and Pancreatic Surgery,Shanghai General Hospital;

• 1:贵州省骨科医院普外科
• 2:镇江市中西医结合医院普外科
• 3:上海交通大学附属第一人民医院肝胆胰外科

摘要(Abstract)：

目的:探讨Ki-67对意外胆囊癌(UGC)术后患者预后判断的临床意义。方法:41例UGC患者,收集胆囊癌的病理分期(TNM分期)、手术方式、胆囊癌组织标本中Ki-67表达水平、术后随访UGC患者的生存时间,对TNM分期、手术方式、胆囊癌组织标本中Ki-67表达水平与UGC患者的生存时间进行单因素分析及Logistic回归分析。结果:随访1～158月的41例UGC患者中,术后存活1年以上共计29例(29/41,70.73%),3年以上共计18例(18/41,43.90%),5年以上存活8例(8/41,19.5%);单因素分析显示,UGC患者的1年和3年生存与肿瘤分期和手术方式显著相关,5年生存与肿瘤分期、手术方式和Ki-67显著相关; Logistic回归分析显示,手术方式和肿瘤分期与1年生存显著相关,肿瘤分期和3年生存呈显著负相关,肿瘤分期和Ki-67与5年生存呈显著负相关。结论:UGC患者胆囊切除标本中Ki-67表达越低,术后的5年生存率越高,Ki-67表达水平对UGC术后患者的预后判断有重要意义。
Objective: To investigate the clinical significance of Ki-67 in judging the postoperative prognosis of patients with unexpected gallbladder cancer( UGC). Methods: Forty one UGC patients were recruited in this study. TNM staging,surgical methods,the Ki-67 expression level in gallbladder cancer tissue specimens and the patient survival time during postoperative follow-up were collected.The association of the TNM staging,operation methods and the Ki-67 expression level with the survival time of UGC patients were analyzed by univariate analysis and Logistic regression analysis. Results:Among the 41 patients,followed up from 1 to 158 months after operation,29 survived over 1 year( 29/41,70. 73%),18 survived for more than 3 years( 18/41,43. 90%),8 survived for more than 5 years( 8/41,19. 5%). Univariate analysis showed that both the 1-year and 3-year survival rates were significantly correlated with the TNM staging and operation methods. And the 5-year survival rate was significantly correlated with the TNM staging,operation methods and Ki-67 expression level. The Logistic regression analysis showed that the 1 year survival rate was significantly correlated with the TNM staging and operation methods,but the 3-year survival rate was significantly,negatively correlated with the TNM staging. In addition,the 5-year survival rate was significantly,negatively correlated with the TNM staging and Ki-67 expression level. Conclusion: The lower the expression level of Ki-67 in the cholecystectomy specimens of UGC patients,the higher the 5-year survival rate after surgery. The expression level of Ki-67 is of great significance to the prognosis of UGC patients.

关键词(KeyWords)： 胆囊切除术,腹腔镜;意外胆囊癌;胆囊癌根治术;Ki-67;生存时间
cholecystectomy,laparoscopic;Unexpected gallbladder cancer;Radical cholecystectomy;Ki-67 expression;survival time

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81672846)

作者(Authors): 田雾;丁海华;于洋;孙红成;
TIAN Wu;DING Haihua;YU Yang;SUN Hongcheng;Department of General Surgery,Orthopaedics Hospital of Guizhou Province;Department of General Surgery,Integrated Chinese and Western Medicine Hospital of Zhenjiang City;Department of Hepatobiliary and Pancreatic Surgery,Shanghai General Hospital;

DOI: 10.19367/j.cnki.2096-8388.2020.10.016

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