Analysis Of Clinical Data Of Hepatolithiasis Associated With Cholangiocarcinoma

Objective：1、To improve diagnosis and treatment of hepatolithiasis complicated withcholangiocarcinoma and hepatolithiasis,we discussed and analysed Clinical datacharacteristics between two groups；2、To observe diagnostic significance of ALP、GGT/ALP associated with CA199and CA242to between hepatolithiasis and hepatolithiasis complicated withcholangiocarcinoma；3、To compare with application effect of BU、CT、MRCP to hepatolithiasiscomplicated with cholangiocarcinoma;Methods：26cases of hepatolithiasis complicated with cholangiocarcinoma and31cases ofhepatolithiasis from2011to2013treated in the first Hospital of Jilin University werecollected and analysed. Then we collected the information of the remaining patients,including general information,blood test, imaging data and pathological characteristics.Subsequently, we performed diagnosis analysis according to the outcome.Results:1、The concurrent rate of HLACCA was4.51%(26/577);The diagnosis ratePreoperation was50%(13/26);The incidence rate of abdominal pain in hepatolithiasisassociated with intra-hepatic cholangiocarcinoma(HLAIHCC) was higher than that ofhepatolithiasis associated with extra-hepatic cholangiocarcinoma(HLAEHCC)(P<0.05),but the ratio of the aundice was opposite between them (P<0.05); Thepositive rate of imageological examination to HLAIHCC is lower than that ofHLAIHCC (P<0.05);2、The incidence rate of abdominal pain and hyperpyrexia inhepatolithiasis associated with cholangiocarcinoma(HLACCA) was lower than that ofhepatolithiasis(P<0.05); The positive rate of detecting abnormal placeholder in imageological examination to HLACCA was significantly higher than themisdiagnosis rate of that to hepatolithiasis（P<0.05）;The incidence of HLACCA inmale was higher than that in female,and it was opposite in hepatolithiasis group（P<0.05）.3、The positive rate of ALP(>168U/L) in HLACCA was significantlyhigher than that in hepatolithiasis group（P<0.05）;4、The positive rate of CA199andCA242was higher in HLACCA （13/18、5/6) than hepatolithiasis group(9/19、8/18)（P>0.05）,while they were not different. The positive rate of CA199in mild atypicalhyperplasia group（4/15) was lower than that of in moderate atypical hyperplasiagroup(5/7)（P<0.05）;5、The positive rate of diagnosis of CT contrast enhancementand MRCP was all high and not different between in hepatolithiasis associated withintra-hepatic and extra-hepatic cholangiocarcinoma group（P>0.05）.Conclusion:1、In hepatolithiasis associated with intra-hepatic cholangiocarcinoma, abdominalpain was occured as the most common symptom;the incidence rate of abdominal painand hyperpyrexia in hepatolithiasis was more commonly than that of hepatolithiasisassociated with cholangiocarcinoma;2、 There was some values of differentialdiagnosis with ALP between hepatolithiasis and hepatolithiasis associated withcholangiocarcinoma;3、Atypical hyperplasia of bile duct epithelial might lead to therise of CA199and CA242for patients in hepatolithiasis group and regarded aspathological basis of cholangiocarcinoma;4、The positive rate of diagnosis of CTcontrast enhancement and MRCP was not different between in hepatolithiasisassociated with intra-hepatic and extra-hepatic cholangiocarcinoma group.