Clinical and prognostic features of 512 cases of cholangiocarcinoma. / 512例胆管细胞癌的临床及预后特点.

OBJECTIVES: Cholangiocarcinoma (CCA) is an aggressive malignant tumor with a poor overall prognosis. Given that CCA is often diagnosed at the late stage, the current treatments are less effective for most local advanced patients leading to high CCA mortality. This study aims to explore the clinical characteristics and prognostic factors affecting the occurrence and development of CCA and to provide potential methods for early diagnosis and clinical treatment of CCA. METHODS: We retrospectively analyzed the medical records of 512 patients with CCA who had been diagnosed by pathology and had completely clinical data in the Second Xiangya Hospital of Central South University in the past 16 years. The clinical features and prognosis related factors that affect the occurrence and development of CCA were investigated. Survival curves were plotted by the Kaplan-Meier method. P-values were calculated by log-rank for univariate analysis, and multivariate Cox regression was used to analyze multivariate analysis of meaningful variables. RESULTS: The incidence of CCA among ≤60 years old people was higher than of that >60 years old one (61.13% vs 38.87%), and was greater in men than women (52.5% vs 47.5%). Carbohydrate antigen 19-9 (CA19-9) level ≥35 µg/L accounted for 66.21%. The single tumor accounted for 86.91%, and patients in pathological stage III and IV accounted for 49.22% and 17.58%, respectively. Univariate analysis showed that ALB, ALP, CA19-9, and other factors were relevant to the prognosis. The results of multivariate analysis showed that ALP, CA19-9, tmaximum tumor diameter, and other factors were significant prognostic predictors. CONCLUSIONS: The incidence of CCA is higher in ≤60 years old people, and the stage is later at the initial diagnosis. CA19-9 level is a sensitive laboratory indicator. ALP, CA19-9, maximum tumor diameter, merged tumor, cirrhosis, and TNM stage are independent prognostic factors for CCA.