Clinicopathological Characteristics And Prognosis Of 85 Cases Of Gallbladder Adenocarcinoma

Objective:The purpose of this study was to determine the clinical and pathologic factors affecting the prognosis of patients with gallbladder adenocarcinoma,Methods:The clinicopathological data of patients with gallbladder adenocarcinoma in the Second Affiliated Hospital of Kunming Medical University from January 2013 to July 2018 were retrospectively analyzed.The possible prognostic factors were calculated by Kaplan-Meier method,and the survival rate was tested by log-rank method.The factors with statistical significance(P<0.05)were analyzed by Cox proportional risk model for multivariate survival analysis.Results:A total of 85 patients with gallbladder adenocarcinoma were included in this study,and 71 cases were followed up,with a follow-up success rate of 83.5%.The median survival time of all subjects was 19 months(range about 2-66 months).The 1-year and 3-year survival rates were 57.2%and 40.3%,respectively.Among the 85 patients,40 patients had recurrence of gallbladder adenocarcinoma,most of which were located in the liver and hilar area,4 patients had retroperitoneal lymph node metastasis,and 3 patients had pulmonary metastasis.,2 patients survived with tumor.The result of single factor survival analysis is that blood type O,ALT,TBIL,CA19-9,CEA,surgical methods,R0 resection,biliary reconstruction,lymphovascular invasion,the degree of pathological differentiation,TNM staging,incidental gallbladder carcinoma are significantly associated with the prognosis of gallbladder factors(P<0.05),and the age,sex,serum HBsAg,ALB,CA125,perineural invasion.accompanied diseases(diabetes,gallbladder polyps and gallbladder stone),abnormal BMI are not related factors of prognosis of gallbladder carcinoma.The significant factors in the univariate analysis were incorporated into the Cox proportional risk model,and CA19-9(P=0.020),R0 resection(P=0.000)and the degree of pathological differentiation(P=0.001)were finally concluded to be independent risk factors related to the prognosis of gallbladder cancer.Conclusion:1.Blood type O,ALT,TBIL,CA19-9,CEA,R0 resection,bile duct construction,lymphovascular invasion,TNM staging,the degree of pathological differentiation are associated with the prognosis of gallbladder carcinoma.2.CA 19-9,R0 resection,the degree of pathological differentiation are independent risk factors of prognosis of gallbladder.