关键词: 胆管上皮癌, 小导管型, 大导管型, 预后

Abstract: Objective To analyze the clinicopathological features and prognostic factors of large duct type and small duct type intrahepatic cholangiocarcinoma (ICCA). 
Methods The clinical data of 91 patients with ICCA were analyzed retrospectively, and the pathological features of large duct type ICCA and small duct type ICCA were compared. Kaplan-Meier survival analysis was used to analyze the recurrence-free survival (RFS) curve and overall survival (OS) curve, and Log-rank method was used to compare the survival rate between groups. Cox proportional hazard model was used to analyze the prognostic factors of patients with large duct type ICCA.
Results Among the 91 patients with ICCA, there were 52 cases with large duct type, 32 cases with small duct type and 7 cases with undetermined type. Compared with the small duct type, patients with large duct type had the characteristics of lymph node metastasis, vascular invasion, high level of serum CA199, high TNM stage and history of hepatolithiasis (P＜0.05). The 1-, 3-and 5-year OS rates in patients with large duct type were significantly lower than those of small duct type (P＜0.05). There was no significant difference in 1-, 3-and 5-year RFS rates between large duct type and small duct type ICCA (P＞0.05). Multivariate survival analysis showed that lymph node metastasis and TNM stage were poor prognostic factors for OS of large duct type ICCA, while vascular invasion and TNM staging were poor prognostic factors for RFS. 
Conclusion There are certain differences in clinicopathological features between large duct type and small duct type ICCA. Patients with large duct type have worse prognosis than those with small duct type. In addition, lymph node metastasis, vascular invasion and TNM stage are factors affecting the OS and RFS.

Key words: cholangiocarcinoma, small duct type, large duct type, prognosis