Adenosquamous carcinoma of the bile duct: a population-based study
Adenosquamous carcinoma of the bile duct: a population-based study
复制标题
胆管腺鳞癌：一项基于人群的研究
DOI：
10.2147/cmar.s144850
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
Zang, Yuan-Sheng
中科院分区：
文献类型：
--
作者：
Qin, Bao-Dong;Jiao, Xiao-Dong;Zang, Yuan-Sheng
胆管腺鳞癌（ASC）是一种罕见的诊断，临床病理学特征和疾病进展知之甚少，因此确定与ASC患者生存相关的特征是必要的。材料与方法使用从1973年至2013年的胆管ASC组织学诊断患者的监测、流行病学和最终结果（SEER）数据库中前瞻性提取的数据进行人群队列研究。结果106例胆管ASC患者，平均年龄（68.1±13.5）岁。肝外胆管病变58例，壶腹部病变34例。57例患者被归类为区域性分期，15例为局部疾病，30例为远处疾病。大多数（60.4%）患者接受了癌症导向手术，14.1%的病例接受了放射治疗。胆管ASC患者的1年、2年和5年总生存率（OS）分别为30.1%、11.3%和3.7%。胆管ASC患者的癌症定向手术提供了额外10个月的OS，乏特壶腹、肝外胆管和肝内胆管病例的中位OS分别为14.0、6.0和6.0个月。多因素考克斯分析显示，壶腹病变（HR=0.51，95%CI 0.26-0.99）和手术（HR=0.34，95%CI 0.14-0.81）是这些患者的独立保护性预后因素。结论原发灶位于壶腹的胆管ASC患者，行根治性手术治疗预后良好。
Introduction Adenosquamous carcinoma (ASC) of the bile duct is a rare diagnosis with poorly understood clinicopathological characteristics and disease progression, so identification of the features associated with ASC patient survival is warranted. Materials and methods A population cohort study was performed using prospectively extracted data from the Surveillance, Epidemiology and End Results (SEER) database for patients with histological diagnoses of ASC of the bile duct from 1973 to 2013. Results A total of 106 patients with ASC of the bile duct were included (mean age 68.1±13.5 years). Lesions from 58 patients were in the extrahepatic bile duct and 34 were located at the ampulla of Vater. Fifty-seven patients were categorized with a regional stage, 15 had localized disease, and 30 had distant disease. Most (60.4%) patients received cancer-directed surgery, and radiation was performed in 14.1% of cases. The 1-year, 2-year, and 5-year overall survival (OS) for patients with ASC of the bile duct was 30.1%, 11.3%, and 3.7%, respectively. Cancer-directed surgery offered 10 additional months of OS for patients with ASC of the bile duct and median OS was 14.0, 6.0, and 6.0 months for ampulla of Vater, extrahepatic bile duct, and intrahepatic bile duct cases, respectively. A multivariate Cox analysis showed that lesions in the ampulla of Vater (HR=0.51, 95% CI 0.26–0.99) and having surgery (HR=0.34, 95% CI 0.14–0.81) were independent protective prognostic factors for these patients. Conclusion Cancer-directed surgery and a primary lesion site of the ampulla of Vater may suggest favorable prognosis for patients with ASC of the bile duct.