| 黄斌.胰腺癌切除术后远期生存的影响因素分析[J].浙江中西医结合杂志,2021,31(1): |
| 胰腺癌切除术后远期生存的影响因素分析 |
| Analysis of factors in influencing long-term survival after radical resection for pancreatic cancer |
| 投稿时间：2020-03-31 修订日期：2020-12-08 |
| DOI： |
| 中文关键词: 胰腺癌 手术切除 预后因素 淋巴转移 远期生存 |
| 英文关键词: |
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| 中文摘要: |
| 目的 探讨影响胰腺癌切除术后远期生存的因素以期改善预后。方法 收集李惠利医院及本院2011.01月至2016.05月接受胰腺癌手术切除连续208例患者的临床、病理及随访资料。重点分析CA199水平,血管切除,肿块大小,淋巴转移,切缘情况等对远期生存率的影响, Kaplan-Meier法绘制生存曲线并行log-rank检验, COX风险回归模型进行多因素分析。结果 本组患者中位生存期为15月,1,3,5年存活率为69.7%,20.6%,11.6%,术后并发症发生率为21.6%,其中胰瘘(B和C级)发生率为6.0%,腹腔内感染为10.1%,围手术期死亡率为0%。单因素分析显示,患者中位生存期与CA199值,切缘阳性,淋巴转移,肿瘤分化程度有关；COX多因素分析显示,肿瘤分化程度,淋巴转移和阳性切缘为影响预后独立危险因素。结论 提高胰腺癌的早期诊断率和手术根治度是现阶段改善胰腺癌切除术预后的主要途径。对术前影像学提示存在淋巴转移及手术切缘阳性可能性较大的患者进行新辅助化疗有可能改善患者的远期生存。 |
| 英文摘要: |
| Objective ToSanalyzeStheSfactorsSthat influencingStheSprognosis of patientsSwithSradical resection of pancreatic cancer and improve it .Methods The clinical ,pathological and follow-up datas of 208 patients with pancreatic cancer who underwent radical resection from January 2011 to March 2016 were retrospectively analyzed . Investigating the peri-operation factors influencing the survival of patients,especially CA199,vascular resection,tumor size,lymphatic metastasis ,margin status. Survival rate was calculated by Kaplan-Meier estimation while survival curve was analysed by Log-rank test. Prognostic factors were studied by multivariate analysis with COX proportional hazards survival model. Results In this group ,the total median survival time was 15 months. Overall survival rates at 1 years,3 years,5 years were 69.7%,20.6 % and 11.6% respectively. The incidence of postoperative complications were 21.6%, The abdominal infection was 10.1%.,The perioperative mortality was nil.Univariate analysis suggested that median survival time was related with CA199, positive resection margin, lymphatic metastasis, tumor stage ; COX multivariate analysis showed that tumor differentiation, lymphatic metastasis, positive resection margin were independent risk factors for dismal prognosis. Conclusion The improvement of early diagnosis rate and the surgery is the main way to enhance the prognosis.May be the new adjunctive therapy can prolong the survival time of patients whose preoperative imaging indicate that lymph node involvement and the highly positive resection margin. |
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