胰腺癌根治切除术后远期疗效的多因素分析  

Factors influencing the long-term survival in pancreatic carcinoma patients after radical resection

作　　者：张维建[1] 韩少良[1] 蒋飞照[1] 朱恒梁[1] 叶百亮[1] 柯庆宏[2] 方瑶[1] 

机构地区：[1]温州医学院附属第一医院外科,325000 [2]浙江大学医学院附属第一医院肝胆胰外科

出　　处：《中华肿瘤杂志》2008年第11期870-872,共3页Chinese Journal of Oncology

摘　　要：目的探讨胰腺癌根治切除术后远期疗效的影响因素。方法回顾性分析184例行根治切除术治疗的胰腺癌患者的临床病理资料，用Cox比例风险模型进行生存率多因素分析。结果184例患者总的1、3和5年生存率分别为61．7％、29．0％和14．3％。肿瘤直径〈3cm者的1、3和5年生存率分别为78．0％、38．4％和25．7％，明显高于肿瘤直径≥3cm者（52．8％、22．7％和7．2％，P〈0．05）；无淋巴结转移者的1、3和5年生存率分别为67．6％、30．5％和17．4％，明显高于有淋巴结转移者（37．1％、20．6％和0，P〈0．05）；Ⅰ期患者的1、3和5年生存率分别为75．2％、47．4％和23．7％，Ⅱ期患者的1、3和5年生存率分别为68．2％、36．3％和21．8％，均明显高于Ⅲ期和Ⅳ期患者（均P〈0．05）。Cox模型分析显示，肿瘤大小和有无淋巴结转移是影响胰腺癌根治术后患者远期疗效的独立因素（P〈0．05和P〈0．01）。结论提高胰腺癌患者远期疗效的关键是早期诊断以及对患者进行根治性切除治疗。Objective To investigate the factors influencing the long-term survival of pancreatic carcinoma patients after radical resection. Methods The data of 184 pancreatic carcinoma patients with radical resection were analyzed retrospectively. Analysis of the prognostic factors influencing the long-term survival was performed using Cox proportional hazard regression model. Results The overall 1-, 3- and 5- year survival rates in this group were 61.7% , 29.0% and 14.3% , respectively. They were 78.0% , 38.4% and 25.7%, respectively, for the patients with a tumor 〈 3 cm in diameter, significantly better than those with a tumor ≥3 cm （52.8%, 22.7% and 7.2%, respectively, P 〈0.05）. Moreover, the 1-, 3- and 5-year survival rates were 67.6% , 30.5% and 17.4%, respectively, in the patients without lymph node involvement, much longer than that in those with lymph node metastasis （37.1%, 20. 6% and 0, respectively, P 〈 0.05 ）. Multivariate analysis by Cox proportional hazard regression model revealed that the tumor size （ P 〈 0.05 ） and lymph node metastasis （P 〈 0.01 ） significantly influenced the long-term survival of the patients. Conclusion Tumor size and lymph node metastasis are significant factors influencing the long-term survival of pancreatic carcinoma patients with radical resection. Therefore, early diagnosis and radical resection are the key points to improve treatment outcome.

关 键 词：胰腺肿瘤 根治切除 生存率 肿瘤大小 淋巴结转移 

分 类 号：R686[医药卫生—骨科学]