96例胰头癌根治术患者术后生存率影响因素分析  

Factors affecting postoperative survival of patients after radical resection of ductal adenocarcinoma of pancreas head: an analysis of 96 cases

作　　者：张怡杰[1] 胡先贵[1] 唐岩[1] 刘瑞[1] 金钢[1] 邵成浩[1] 何天霖[1] 虞慧婷[2] 

机构地区：[1]第二军医大学长海医院普通外科,上海200433 [2]第二军医大学卫生勤务学系统计学教研室

出　　处：《第二军医大学学报》2005年第8期848-850,共3页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(30200275).

摘　　要：目的:探讨以区域淋巴结廓清为重点的胰头癌根治术后生存率的主要影响因素。方法:采用Cox模型分析1996～2004年间的96例以区域淋巴结廓清为重点的胰头癌根治术患者术后生存率与性别、年龄、手术时间、术中出血量、输血量、CA199水平、肿瘤大小、肿瘤组织学分型、淋巴结转移等指标的关系。结果:全组无手术死亡。96例患者术后1、2、3、5年的存活病例数分别为55、30、15、7例,1、2、3、5年累积生存率分别为78.1%、54.9%、37.0%、23.1%。患者术后生存率与肿瘤大小(P<0.0001)、肿瘤组织学分型(P=0.0005)、有无淋巴结转移(P=0.0092)显著相关,而与其他指标无显著相关性。结论:胰头癌的肿瘤大小、组织学分型以及是否有淋巴结转移对手术预后有重要影响;在重视胰头癌早期诊断的同时,加强手术彻底性对提高胰头癌的长期生存率至关重要。Objective：To discuss the factors influencing the survival rate of patients after radical resection of ductal adenocarcinoma of pancreas head. Methods： From 1996 to 2004, 96 patients with ductal adenocarcinoma of pancreas head underwent pancreaticoduodenectomy and regional lymphadenectomy. The relationship between the post-operation survival rate and patients＇sex, age, operation time, blood loss and transfusion during operation, preoperative CA19-9 level, tumor size, tumor type and grade, and lymph node metastasis were analyzed by a COX model. Results： There was no operative death. Of the 96 patients, 55 survived for 1 year, 30 for 2 years, 15 for 3 years, and 7 for 5 years. The 1-, 2-, 3- and 5-year cumulative survival rate was 78. 1%, 54.9%, 37.0% and 23.1%, respectively. COX model indicated that post-operation survival rates were significantly related with tumor size （P〈0. 000 1）, tumor differentiation degree （P=0. 000 5） and lymph node metastasis （P=0.009 2）, but not with the other factors. Conclusion： Tumor size, tumor differentiation degree and lymph node metastasis have great influence on post-operation survival of patients with ductal adenocarcinoma of pancreas head. Early diagnosis and radical resection with regional lymphadenectomy are also key factors for long-term survival.

关 键 词：胰腺肿瘤 外科手术 淋巴结廓清 生存率 

分 类 号：R735.9[医药卫生—肿瘤]