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| 題名: | Molecular epidemiology of Bartonella henselae infection in human immunodeficiency virus-infected patients and their cat contacts, using pulsed-field gel electrophoresis and genotyping |
| 作者: | Chang, CC;Chomel, BB;Kasten, RW;Tappero, JW;Sanchez, MA;Koehler, JE |
| 貢獻者: | 公共衛生學院公衛系;Univ Calif Davis, Sch Vet Med, Dept Populat Hlth & Reprod, Davis, CA 95616 USA;China Med Coll, Dept Publ Hlth, Taichung, Taiwan;Univ Calif Berkeley, Sch Publ Hlth, Program Epidemiol, Berkeley, CA 94720 USA;Univ Calif San Francisco, Dept Med, Div Infect Dis, San Francisco, CA USA;Ctr Dis Control & Prevent, Meningitis & Special Pathogens Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA USA |
| 日期: | 2002 |
| 上傳時間: | 2010-09-24 13:54:59 (UTC+8) |
| 出版者: | UNIV CHICAGO PRESS |
| 摘要: | Background: Hepatolithiasis is a well-known etiology of cholangiocarcinoma. However, whether or not hepatolithiasis influences the presentation of cholangiocarcinoma is not very clear. To help clarify this, we conducted the present study to investigate the clinicopathological characteristics of cholangiocarcinoma with hepatolithiasis. As well, we made a comparison between the presence and absence of hepatolithiasis in patients with cholangiocarcinoma to determine the impact of hepatolithiasis. Methods: Among 140 patients with histologically proven cholangiocarcinoma at the Taichung Veteran General Hospital between October 1982 and December 2000, 38 were found to have concomitant hepatolithiasis. Patients were evaluated on the basis of age, gender, presenting symptom, laboratory data, preoperative liver function (indocyanine green test), tumor markers, histological differentiation, lymph node involvement, and organ metastasis. Data were statistically analyzed using the chi-squared test and Student's t-test. Analysis of survival was performed using the Kaplan-Meier method, and univariate analysis and multivariate analyses for survival were performed by Cox proportional hazard model. Results: The cholangiocarcinoma with hepatolithiasis group (CC+ HL) was found to be predominantly female, with more common presentation of fever and less presentation of jaundice (P < 0.05). In addition, patients with cholangiocarcinoma without hepatolithiasis (CC - HL group) had higher serum bilirubin levels and more advanced histological differentiation (P < 0.05). As well, the percentage of resectability of the CC + HL group was higher than that of the CC-HL group, although it was not statistically significant. Univariate and multivariate analyses for overall survival showed that those patients with an age older than 65 years, hypoalbuminemia, poor histological differentiation, and a presence of hepatolithiasis were prone to a graver prognosis, albeit none of them were statistically significant. Resectability was the only independent predictor of a favorable prognosis with significant difference. Conclusions: The clinicopathological features of cholangiocarcinoma with concomitant hepatolithiasis showed few differences from that without hepatolithiasis. Resectability was the only predictor that favored a good prognosis. (C) 2002 Blackwell Publishing Asia Pty Ltd. |
| 關聯: | JOURNAL OF INFECTIOUS DISEASES 186(12):1733-1739 |
| 顯示於類別: | [公共衛生學系暨碩博班] 期刊論文
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