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目的探讨不同治疗方式对浸润深度局限于胆囊壁内的T1、T2期胆囊癌预后的影响。方法对浸润深度局限于胆囊壁内的45例T1和T2期胆囊癌患者的预后进行回顾分析。结果Cox多因素分析显示肿瘤浸润深度(T)、胆囊癌根治术以及术后化疗是影响预后的三个独立的因素。在未用化疗的情况下T1a期、T1b期和T2期胆囊癌在单纯胆囊切除术后的5年生存率分别为100%、67%和0,T1b期与T2期两组生存差异有统计学意义。在未用化疗的情况下T2期胆囊癌在单纯胆囊切除和胆囊癌根治术后的5年生存率分别为0和63%。T2期胆囊癌在单纯胆囊切除术后使用化疗与未用化疗的生存差异有统计学意义。结论T1期胆囊癌预后明显优于T2期胆囊癌。T1a期和T1b期胆囊癌在单纯胆囊切除术后即可获得比较满意的5年生存率。胆囊癌根治术和化疗均可以改善T2期胆囊癌的预后。
Objective To investigate the effects of different treatment methods on the prognosis of T1 and T2 gallbladder carcinomas with infiltration depth confined in gallbladder wall. Methods The prognosis of 45 patients with gallbladder carcinoma of T1 and T2 whose infiltration depth was confined to the gallbladder wall were retrospectively analyzed. Results Cox multivariate analysis showed that the depth of tumor infiltration (T), gallbladder carcinoma and postoperative chemotherapy were three independent factors affecting the prognosis. The 5-year survival rates of T1a, T1b and T2 gallbladder carcinoma after cholecystectomy without chemotherapy were 100%, 67% and 0, respectively. The difference in survival between T1b and T2 was statistically significant significance. The 5-year survival rates of T2 gallbladder carcinoma after radical cholecystectomy and gallbladder carcinoma without chemotherapy were 0 and 63% respectively. There was significant difference in the survival of T2 gallbladder carcinoma between chemotherapy and non-chemotherapy after cholecystectomy. Conclusion The prognosis of T1 gallbladder carcinoma is better than that of T2 gallbladder carcinoma. T1a and T1b gallbladder cancer after cholecystectomy can be satisfied with the 5-year survival rate. Gallbladder cancer and chemotherapy can improve the prognosis of T2 gallbladder cancer.