Intrahepatic biliary cystadenocarcinoma of 17 cases / 中华普通外科杂志

ABSTRACT

Objective To explore the clinical features, treatment and prognosis of intrabepatic biliary cystadenocarcinoma (IBC). Methods We retrospectively analyzed clinical data of 17 patients with pathologically confirmed IBC, treated between January 2002 and September 2007. Results Of the 17 patients, 4 were men and 13 were women, with a mean age of 49.3 years (range 45 -68). Serum level of AFP was normal in all patients. CA19-9 was abnormally elevated in only two patients and the other two had abnormal serum level of CEA. Seven cases underwent radical resection, 7 underwent complete tumor resection combined with removal of tumor thrombi in the bile duct, 3 received palliative surgery. On histopathological examination, 10 were biliary cystadenocarcinoma,2 were biliary cystadenoma with partial eanceration,2 were papillary cystadenocarcinoma,2 were mutinous papillary cystadenocarcinoma and 1 was of mixed cystadenocarcinoma and hepatocellular carcinoma. According to tumor differentiation, the number of well, moderate and poor-differentiated group was 7, 3 and 7 cases respectively. The medality of surgery (β= - 0.692, P = 0.01) and tumor differentiation (β = - 2.041, P = 0.007) effected the prognosis significantly. Conclusions IBC occurs mainly in elderly women. CA19-9 examination does not help in the establishment of diagnosis of IBC. The occurrence of tumor thrombosis in common bile duct doesn't necessarily indicate poor prognosis, hence a IBC patient will still have a satisfactory prognosis should the primary tumor be completely resected and tumor thrombi removed.