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Detection of benign hilar bile duct stenoses – A retrospective analysis in 250 patients with suspicion of Klatskin tumour

机译:良性肝门胆管狭窄的检测–回顾性分析250例怀疑为Klatskin肿瘤的患者

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Introduction The aim of this study was to identify clinical, laboratory and radiological parameters to distinguish benign from malignant stenoses of the proximal bile duct. Methods Between 1997 and 2011, 250 patients were referred to our clinic with hilar bile duct stenoses suspicious for Klatskin tumour. Medical histories, clinical data, pre-interventional laboratory tests, imaging findings, as well as therapeutic approach and patient outcome were compared to final histological results. All data were retrieved from our prospectively maintained database and analysed retrospectively. Results We found benign bile duct lesions in 34 patients (13.6%). Among the entire study population, uni- and multivariate analyses of 18 clinicopathological parameters revealed that patient age, serum alkaline phosphatase, tumour marker CA19-9 and presence of tumour mass in computed tomography were independent predictors for malignant biliary stenoses (p?
机译:引言这项研究的目的是确定临床,实验室和放射学参数,以区分良性与近端胆管恶性狭窄。方法1997年至2011年间,有250例因可拉特斯金瘤可疑的肝门胆管狭窄症被转诊至我们的诊所。将病史,临床数据,介入前实验室检查,影像学发现以及治疗方法和患者预后与最终的组织学结果进行比较。所有数据均从我们前瞻性维护的数据库中检索并进行回顾性分析。结果我们发现34例患者的胆管良性病变(13.6%)。在整个研究人群中,对18种临床病理参数的单因素和多因素分析表明,患者年龄,血清碱性磷酸酶,肿瘤标志物CA19-9和计算机断层摄影术中的肿瘤肿块是恶性胆管狭窄的独立预测因素(p <0.05)。 )。接收者操作者特征曲线表明,CA19-9血清水平为61.2?U / ml或更高时,预测肝门胆管狭窄恶性程度的敏感性,特异性和诊断准确性分别为74.6%,80.0%和83.5%。 34例良性病变患者中有10例可以通过术前检查和手术探查来避免手术切除。良性病变组的主要肝脏切除率为66.7%,克拉特斯金瘤组为90.7%。结论尽管术前诊断有所改善,但仍难以区分良性和恶性肝门胆管狭窄。即使是探查性剖腹手术也不能在所有情况下安全地排除Klatskin肿瘤,因此不可避免地需要进行大的肝切除术。强调 ?鉴定临床,实验室和放射学参数,以区分良性与近端胆管恶性狭窄。 ?回顾性分析250例怀疑患有Klatskin肿瘤的患者。 ?患者年龄,碱性磷酸酶,CA19-9和CT扫描中肿瘤块的存在是近端胆管恶性狭窄的预测因素。

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