Clinical Comparison Of Hepatocellular Carcinoma And Intrahetapic Cholangiocarcinoma

Objective:To investigate the clinical features and prognostic factors of hepatocellular carcinoma and intrahepatic cholangiocarcinoma in primary liver cancer,in order to deepen the understanding of the disease and reduce clinical misdiagnosis and mistreatment.Methods:Retrospective study clinical date of 225 patients with HCC(HCC group)and 37 patients with ICC(ICC group)who underwent surgical treatment and postoperative pathology at the First Affiliated Hospital of Xinjiang Medical University from August2010 to May 2017.Comparative analysis was made from the etiology,clinical features,laboratory tests,imaging examinations,and pathological features.Follow-up by returning to hospital for review or telephone method.Survival curves were analyzed by Kaplan-Meier method.The risk factors of postoperative prognosis in patients with HCC and ICC were analyzed by single factor and multivariate Cox models.Results:HCC is mostly male,and ICC merges with previous/existing history of biliary tract disease;The proportion of HCC with a history of hepatitis B and family history was significantly higher than that of ICC;The proportion of jaundice and stones in ICC was significantly higher than in HCC.The positive rate of bilirubin,?-gammaglutamgl transpeptidase,and alkaline phosphatase in ICC was significantly higher than that in HCC.The positive rate of AFP in HCC was significantly higher than that in ICC.The positive rate of CA19-9 and CEA in ICC was significantly higher than that in HCC.HCC is easy to be combined with cirrhosis,the proportion of intrahepatic bile duct dilatation in ICC is higher than HCC,and it is prone to intrahepatic metastasis;HCC is mostly in the right lobe of the liver,and ICC is mostly in the left lobe of the liver.Hepatic lesions are the main methods of HCC and ICC surgery.The proportion of abdominal node metastasis in ICC is higher than that in HCC.The1-,3-,and 5-year survival rates after HCC were 85.1%,54.5% and 38%,respective ly.And the1-,3-,and 5-year survival rates after ICC were75.7%,17.1% and 10.2%,respectiv ely.Univariate results showed that liver function Child-Pugh classification,AFP,cirrhosis,tumor size,abdominal lymph node metastasis,portal vein tumor thrombus,microvascular invasion,TNM stage and HCC prognosis were statistically correlated.Multivariate resultsshowed that liver function Child-Pugh grade C,cirrhosis with liver,abdominal lymph node metastasis,TNM phase3,4 are risk factors in affecting the prognosis of HCC.Univariate results showed that CA19-9,CEA,tumor size,and abdominal lymph node metastasis were statistically associated with ICC prognosis.So multivariate results showed that CEA and lymph node metastasis were risk factors affecting the prognosis of ICC.Conclusion: Altho ugh HCC and ICC belong to the same primary liver cancer,there are differences in etiology,clinical manifestations,laboratory tests,imaging examinations,postoperative pathology,etc.and deepen the understanding of the disease.