壶腹癌胰十二指肠切除术后预后影响因素的Meta分析  

Prognostic factors of carcinoma of the ampulla of Vatar after pancreatoduodenectomy:a systemic review and meta-analysis

作　　者：姚厚山[1] 王强[1] 王伟军[1] 余宏宇[1] 许超[1] 胡志前[1] 

机构地区：[1]第二军医大学附属长征医院普通外科,上海200003

出　　处：《肝胆胰外科杂志》2009年第5期352-355,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的通过综合评价总结出影响壶腹癌预后的因素,为壶腹癌患者的预后判断及个性化治疗提供依据。方法对符合入选标准的1995年至今公开发表的关于壶腹癌术后生存分析的研究进行Meta分析,并计算每个危险因素的优势比值(OR值)以及其95%可信区间(95%CI)。结果共纳入文献13篇,累积病例986例。局部浸润(浸润至胰腺、浸润至十二指肠壁、浸润至Oddi括约肌外)、淋巴结转移、输血、肿瘤分化程度对壶腹癌术后5年死亡率影响的合并后P值及OR值分别为P<0.001,OR=4.74、P=0.01,OR=2.75、P<0.001,OR=4.25、P<0.001,OR=4.16、P<0.001,OR=2.56、P=0.002,OR=2.38。结论肿瘤局部浸润(浸润至胰腺、浸润至十二指肠壁、浸润至Oddi括约肌外)、淋巴结转移、输血、肿瘤分化程度均为壶腹癌预后影响因素。Objective To identify prognostic factors of carcinoma of the ampulla of Vatar after pancreatoduodenectomy, and provide evidence for survival evaluation and individualization treatment. Methods Publications referring to survival analysis of carcinoma of the ampulla of Vatar and matched the including criterion were analyzed by Meta-analysis, from which the odds ratio （OR） and 95% confidence intervals （95% CI） were calculated. Results Thirteen publications containing 986 participants were analyzed in meta-analysis, the P value and OR of the local invasion （pancreas invasion, duodenum wall invasion, invasion out of the Oddi muscle）, lymph node metastasis, bloods transfusion and histology differentiation were P〈0.001, OR=4.74; P= 0.01, OR=2.75; P〈0.001, OR=4.25; P〈0.001, OR=4.16; P〈0.001, OR=2.56 and P=0.002, OR=2.38 respectively. Conclusion Local invasion （pancreas invasion, duodenum wall invasion, invasion out of the Oddi muscle）, lymph node metastasis, bloods transfusion and histology differentiation are prognostic factors of carcinoma of the ampulla of Vatar after pancreatoduodenectomy.

关 键 词：肝胰管壶腹肿瘤 胰十二指肠切除术 预后影响因素 META分析 

分 类 号：R735.0[医药卫生—肿瘤]