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中国癌症防治杂志

中国癌症防治杂志 ›› 2021, Vol. 13 ›› Issue (2): 126-132.doi: 10.3969/j.issn.1674-5671.2021.02.03

• 癌情监测 • 上一篇    下一篇

中国肝细胞癌和肝内胆管细胞癌临床诊疗情况比较研究

  

  1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院肿瘤登记办公室；深圳市慢性病防治中心肿瘤防控科湖北省肿瘤医院肿瘤防治办公室 
  • 出版日期:2021-04-25 发布日期:2021-04-30
  • 通讯作者: 张思维 E-mail：zhangsw@cicams.ac.cn； 张敏， E-mail：hbskaxh@163.com
  • 基金资助:
    国家重点研发计划项目（2016YFC1302502）；中国医学科学院医学与健康科技创新工程（2019?I2M?2?004；2018?I2M?3?003）；深圳市医疗卫生三名工程（SZSM 201911015）

 A comparative study on clinical diagnosis and treatment of hepatocellular carcinoma and intrahepatic cholangiocarcinoma in China

  • Online:2021-04-25 Published:2021-04-30

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摘要： 目的 分析中国多中心肝细胞癌（hepatocellular carcinoma，HCC）和肝内胆管细胞癌（intrahepatic cholangio-carcinoma，ICC）的临床诊疗情况，为制定肝癌防治措施提供依据。方法 研究对象来源于2016—2017年全国12个省市33家医院首次确诊/治疗的新发HCC和ICC病例，收集病例基本信息、危险因素以及临床诊疗等信息，并比较两种肝癌的分布特点。结果 共收集3 258例肝癌患者，其中男性2 671例（81.98%），女性587例（18.02%）；HCC患者2 928例（89.87%），ICC患者330例（10.13%），两类肝癌患者的构成均为男性高于女性，城市多于农村。HCC和ICC患者的平均发病年龄分别为（56.44±11.65）岁和（61.20±10.92）岁。HCC患者中有吸烟史的患者比例（43.64% vs 33.44%，P=0.0004），有饮酒史患者比例（31.14% vs 22.15%，P=0.0008），有肝疾病史患者比例（67.74% vs 34.16%，P<0.0001），乙型肝炎病毒携带者比例（79.37% vs 64.55%，P=0.0002）均高于ICC。HCC患者的早期（Ⅰ和Ⅱ期）和晚期（Ⅲ和Ⅳ期）构成比分别为44.10%、55.90%，ICC患者分别为17.01%、82.99%，差异有统计学意义（P<0.0001）。HCC和ICC患者主要选择的治疗方式为手术、介入治疗和化疗，手术率分别为60.64%、45.31%，介入治疗率分别为23.86%、21.50%，化疗率分别为22.13%、24.77%。结论 我国HCC和ICC患者的分布特点存在差异性，首次诊断晚期比例均较高，主要治疗方式为手术、介入治疗和化疗。HCC是肝癌最常见的病理类型，男性及中老年人群是肝癌防控工作的重点。

关键词: 肝细胞癌, 肝内胆管细胞癌, 临床诊疗, 病理类型, 分期

Abstract: Objective  To analyze the clinical diagnosis and treatment of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) from various clinical centers in China, and to provide the evidence for prevention and treatment measures. Methods The studied objects were gathered from new HCC or ICC cases diagnosed/treated for the first time in 33 hospitals in 12 provinces and cities from 2016 to 2017. The basic information, risk factors, clinical diagnosis and treatment information were collected, and the distribution characteristics of HCC and ICC were compared. Results A total of 3, 258 liver cancer patients HCC were collected, including 2, 671 males (81.98%) and 587 females (18.02%), with 2, 928 HCC patients (89.87%) and 330 ICC patients (10.13%). In both HCC and ICC patients, the proportion of males were higher than that of females, and the urban patients were more than the rural patients. The mean onset ages of HCC and ICC were (56.44±11.65) and (61.20±10.92) years, respectively. In HCC patients, the proportions of patients with smoking history (43.64% vs 33.44%, P=0.0004), with alcohol drinking history (31.14% vs 22.15%, P=0.0008), with a history of liver related disease (67.74% vs 34.16%, P<0.0001) and hepatitis B virus carriers(79.37% vs 64.55%, P=0.0002)were all higher than those in ICC patients. The proportions of HCC patients at early stage (Ⅰ-Ⅱ stage) and advanced stage (Ⅲ-Ⅳ stage) were 44.10% and 55.90%, respectively, while those of ICC patients were 17.01% and 82.99%, respectively, with statistically significant differences (P<0.0001). The main treatment options for HCC and ICC patients were surgery, interventional therapy and chemotherapy, the ratios of surgery were 60.64% and 45.31%, respectively; the ratios of interventional treatment were 23.86% and 21.50%, respectively; the ratios of chemotherapy were 22.13% and 24.77%, respectively. Conclusions The distribution characteristics of the HCC and ICC patients in China are different, and the proportion of advanced stage at the first diagnosis is high, and the main treatment options are surgery, interventional treatment and chemotherapy. HCC is the most common type of liver cancer, the prevention and control of liver cancer should be focused on male, middle?aged and elderly people.

Key words: Hepatocellular carcinoma, Intrahepatic cholangiocarcinoma, Diagnosis/ Treatment , Histological subtype, Stage

中图分类号: 

  • R735.7