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目的探讨肝门部胆管癌术前改良T分期系统的临床应用价值。方法按术前改良T分期系统回顾分析中山大学第一医院2001年1月至2006年12月收治127例肝门部胆管癌病人的临床资料。结果T1期75例,T2期19例,T3期33例;其切除率分别为61.33%,52.63%,21.21%;根治性切除率分别为40.63%,30.77%,6.90%,均随T分期增高而下降(均P<0.01)。T1期1、3、5年存活率分别为55.9%、37.7%、30.1%,T2期1年为37.5%,T3期1、2年为48.1%、12.0%。用Log-rank法比较差异无显著性意义;用Breslow法比较T1期与T2期差异有显著性意义,T2与期T3期、T1期与T3期比较差异无显著性意义。结论T分期系统有较好的术前评价作用,可用于判断肝门部胆管癌可切除性及手术方式选择,但仍有待完善。
Objective To investigate the clinical value of preoperative modified T staging system in hilar cholangiocarcinoma. Methods According to the preoperative modified T staging system, the clinical data of 127 patients with hilar cholangiocarcinoma admitted to the First Hospital of Sun Yat-sen University from January 2001 to December 2006 were retrospectively analyzed. Results There were 75 cases in stage T1, 19 cases in stage T2 and 33 cases in stage T3. The resection rates were 61.33%, 52.63% and 21.21% respectively. The radical resection rates were 40.63%, 30.77% and 6.90% But decreased (all P <0.01). The survival rates at T1, 1, 3 and 5 years were 55.9%, 37.7% and 30.1% respectively. The 1-year survival rate was 37.5% in T2 stage and 48.1% and 12.0% in T1 and T2 stages, respectively. There was no significant difference by Log-rank method. There was significant difference between T1 and T2 by Breslow method. There was no significant difference between T2 and T3, T1 and T3. Conclusion T staging system has a good preoperative evaluation of hilar cholangiocarcinoma can be used to determine the resectability and surgical options, but still need to be improved.