应用Cox模型多因素分析原发性胆囊癌预后  

Postoperative prognostic analysis of patients with primary gallbladder cancer by Cox model

作　　者：王小坤[1] 暨玲[1] 阮小蛟[1] 郑志海[1] 胡如英[1] 蒋飞照[1] 郑晓风[1] 

机构地区：[1]温州医学院第一附属医院腔镜外科,浙江温州325000

出　　处：《肝胆胰外科杂志》2012年第1期22-26,共5页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的分析影响胆囊癌预后有关的临床病理因素,探讨提高胆囊癌疗效的措施。方法回顾性研究分析我院2006年1月至2010年12月收治的96例胆囊癌患者的临床资料,对可能影响预后的因素进行Kaplan-Meier法及log-rank检验,并通过Cox比例风险回归模型对其临床病理因素进行多因素分析。结果全组共有89例获得随访,患者中位生存期为21.29个月,总的1年、3年、5年生存率分别为71.1%、38.2%、19.6%。经Cox比例风险回归模型分析,术前血总胆红素、手术切除类型、有无神经浸润、病灶浸润深度是影响胆囊癌患者生存时间的独立预后因素。结论早期发现胆囊癌,并进行根治性切除是改善胆囊癌患者预后的关键因素。Objective To analyze the clinicopathological factors that would affect the prognosis of gallbladder carcinoma patients,and investigate the approach of improving the curative effect of gallbladder carcinoma.Methods The clinical data of 96 patients with gallbladder cancer treated in our hospital from January 2006 to December 2010 was retrospectively analyzed.The influence of each variable on survival was determined using the Kaplan-Meier method and log-rank test,and Cox proportion hazard regression model was adopted to analyze the multivariate clinicopathological factors.Results Eighty-nine patients were followed-up in this group.The median survival time of the full group was 21.29 month,and the overall survival rates of 1-year,3-year,5-year were 71.1%,38.2% and 19.6% respectively.Cox regression analysis revealed that pre-operative blood total bilirubin concentration,operation style,tumor infiltration and neural infiltration were the independent prognostic factors.Conclusion Discovering early stage gallbladder cancer and performing radical resection are critical to improve the prognosis of patients with gallbladder cancer.

关 键 词：胆囊肿瘤 根治性手术 COX模型 多因素分析 预后 

分 类 号：R735.8[医药卫生—肿瘤]