中国普通外科杂志2026，Vol.35Issue(2)：260-268,9.DOI:10.7659/j.issn.1005-6947.250513
基于双中心数据的肝门部胆管癌术前淋巴结转移预测模型构建
Development of a preoperative prediction model for lymph node metastasis in perihilar cholangiocarcinoma based on dual-center data
摘要
Abstract
Background and Aims:Lymph node metastasis(LNM)markedly impairs survival in patients with perihilar cholangiocarcinoma(pCCA).However,reliable preoperative predictors of pathological LNM remain limited.This study aimed to identify independent preoperative predictors of LNM and to develop a clinically applicable prediction model. Methods:A total of 327 consecutive patients with pCCA who underwent curative-intent resection between October 2020 and October 2024 at the First Affiliated Hospital of Army Medical University(Southwest Hospital)and the Affiliated Hospital of Qinghai University were retrospectively enrolled.Patients were stratified into LNM-positive(n=131)and LNM-negative(n=196)groups according to postoperative pathological findings.Baseline characteristics were compared between the two groups.Univariate and multivariable logistic regression analyses were performed to identify independent predictors of pathological LNM.A nomogram was subsequently constructed based on the multivariable model. Results:Patients with LNM had significantly shorter median overall survival(16.0 months vs.42.0 months)and recurrence-free survival(12.0 months vs.32.0 months)compared with those without LNM(both P<0.001).Multivariable logistic regression analysis demonstrated that age≥65 years was a protective factor(OR=0.556,P=0.021),whereas CA19-9≥200 U/mL(OR=2.266,P=0.001)and radiologic suspicion of nodal involvement(OR=2.917,P=0.001)were independently associated with an increased risk of pathological LNM.The resulting nomogram demonstrated the ability to provide an individualized quantitative estimate of preoperative LNM risk. Conclusion:Age,CA19-9 level,and radiologic nodal status independently predict pathological LNM in pCCA.The proposed nomogram provides a simple and clinically practical tool for preoperative risk stratification and surgical planning.关键词
Klatskin肿瘤/肝切除术/淋巴转移/危险因素/预后Key words
Klatskin Tumor/Hepatectomy/Lymphatic Metastasis/Risk Factors/Prognosis分类
医药卫生引用本文复制引用
游金杉,李子沐,简睿,王志鑫,刘智鹏,戴海粟,白洁,江艳,陈志宇..基于双中心数据的肝门部胆管癌术前淋巴结转移预测模型构建[J].中国普通外科杂志,2026,35(2):260-268,9.基金项目
重庆市中青年医学高端人才基金资助项目(524Z28F1). （524Z28F1）
