肝内胆管癌の肉眼型と予後因子の検討

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  • MACROSCOPIC CLASSIFICATION AND PROGNOSTIC FACTORS OF INTRAHEPATIC CHOLANGIOCARCINOMA

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Twenty-four cases of intrahepatic cholangiocarcinoma resected in our hospital in the 12 years from 1986 to 1997 were studied with respect to macroscopic classification and prognostic factors. 20.8% of the patients had stones of the intrahepatic or common bile duct. The serum level of carcinoembryonic antigen and of carbohydrate antigen 19-9 was positive in 38.1% and in 86.4% of the patients, respectively. The outcome were poor: one-and five-year survival rates were 55.3% and 22.1%, respectively.<br> Macroscopic classification was made into mass-forming, periductal infiltrating, and intraductal growth types, following a report of The Liver Cancer Study Group of Japan (1994). The outcomes of the mass-forming type (n=9) and the periductal infiltrating type (n=11) were very poor and showed no significant difference. But the patients of the intraductal growth type (n=4) were all living with good prognoses. Prognostic factors were examined according to the Classification of Primary Liver Cancer (Third Edition, 1992). Lymph node involvement, serosa invasion, and portal invasion were significant indicators of a poor prognosis.

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