目的：总结原发性胆囊癌患者的临床、病理特征，探讨影响胆囊癌患者预后的因素。方法回顾性分析2007年至2010年就诊于弋矶山医院的67例原发性胆囊癌患者，对可能影响预后的因素Kaplan－Meier生存分析和Log－rank分析，然后应用Cox比例风险模型对有意义的因素进行多因素分析。结果单因素分析表明胆囊颈切缘阳性、胆囊结石、淋巴结转移、血管转移、肿瘤分化类型、肿瘤原发位置、血清CA199水平及手术方式（ P ＜0．05）对胆囊癌的预后有影响；多因素方差分析结果表明胆囊结石、淋巴结转移、血管转移、手术方式的胆囊癌预后的独立危险因素。结论胆囊结石、淋巴结转移、血管转移及手术方式是胆囊癌预后的独立危险因素。早期诊断、抗感染治疗及手术治疗对于提高胆囊癌患者预后具有重要意义。%Objective To summarize the clinical and pathological features of patients with primary gallbladder carcinoma and to evaluate the prognostic factors of gallbladder carcinoma.Methods 67 gallbladder carcinoma patients in the YiJiShan Hospital From 2007 to 2010 were selected and analysised, Kaplan-Meier survival analysis and Log-rank analysis were carried out on the factors that may affect the prognosis of patients, and then the meanfuling factors were analyzed by Cox proportional hazards model.Results The univariate ananlysis showed that the gallbladder neck cut edge positive, gallbladder stones, lymph node metastasis, vascular metasta-sis, tumor differentiation type, tumor location, serum CA19-9 level and the surgical approach were significantly correlated with the prognosis of the patients ( P <0.05);The results of the multivariate analysis ( Cox regression) showed that gallbladder stones, lymph node metastasis, vascular metastasis, and the surgical approach were independent predicators.Conclusion Gallbladder stones, lymph node metastasis, vascular metastasis and the surgical procedures are independent prognostic factors for gallbladder carcinoma.There-fore, early diagnosis, anti-infective therapy and radical surgery are greatly needed to improve the prognosis of gallbladdercarcinoma.
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