Analysis Of The Relation Between The Clinicopathologic Features And Prognosis Of Cholangiocarcinoma

ObjectiveFrom investigating different parts of cholangiocarcinoma and their clinicopathologic features,prognostic factors,the relation between of them, provide the reference for the cholangiocarcinoma's diagnosis,treatment and prognosis.MethodsCollect the clinicopathologic features'information of 443 cases with cholangio- carcinima, and submit them to a retrospective cohort study. Among them, 187 cases were intrahepatic cholangiocarcinoma, 138 cases were hilar cholangiocarcinoma, 118 cases were distal cholangiocarcinoma. 25 clinicopathologic variables were submitted to the univariate analysis by SPSS 13.0 statistical software to evaluate their prognosis, those with statistical significance would integrate other factors to submit a Cox model multivariate analysis.Results1. Intrahepatic cholangiocarcinomaThe accumulative 1-,3-,5-year survival rates were 62%,24%,20% respectively,and the median survival time was 16.9 months. Multivariate analysis revealed that 5 variables were significantly relative to the survival time of ICC, including TNM stage(p=0.020), age(=0.040), liver fluke(p=0.039),HBV+(p=0.001)and vascular invasion(p=0.002).2. Hilar cholangiocarcinomaThe accumulative 1-, 3-, 5-year survival rates were 49%,16%,8%respectively,and the median survival time was 11.7 months. Multivariate analysis revealed that 3 variables were significantly relative to the survival time of hilar cholangiocarcinoma,including TNM stage(p=0.011), organ invasion(p=0.032)and surgical procedure(p=0.018).3. Distal cholangiocarcinomaThe accumulative 1-, 3-, 5-year survival rates were 70%,38%,25%respectively,and the median survival time was 23.4 months.Multivariate analysis revealed that 2 variables were significantly relative to the survival time of distal cholangiocarcinoma, including chronic disease(p=0.007)and histopathological grade(p=0.048).4. The comparison with three different parts of cholangiocarcinomaStatistical analysis revealed that 3 variables were significantly different in 3 different parts of cholangiocarcinoma, including the survival time(p=0.001),age(p<0.001)and histopathological grade(p<0.001).And 10 variables had no significant difference among 3 different parts of cholangiocarcinoma, including sex(p=0.087),HBV+ (p=0.264), liver fluke(p=0.142),calculus of bile duct(p=0.174),prealbumin(p=0.504),lymph node meta- stasis(p=0.296), CK18(p=0.054),CK19(p=0.267),CD34(p=0.122) and P53(p=0.546).Conclusion1.TNM stage, age, liver fluke,HBV+and vascular invasion were important prognosic factors of ICC.2.TNM, organ invasion and surgical procedure were important prognosic factors of hilar cholangiocarcinoma.3.Chronic disease and histopathological grade were important prognosic factors of distal cholangiocarcinoma.4. ICC, hilar cholangiocarcinoma and distal cholangiocarcinoma had same or similar clinicopatholgic features.They could be studied as one kind of disease.