新疆维吾尔族与汉族入院治疗胰腺癌患者353例预后因素分析  

Prognostic analysis of 353 pancreatic cancer patients in hospital treatment between Uygur and Han nationality in Xinjiang

作　　者：孙岩娜[1] 张华[1] 张瑞丽[1] 才层[1] 艾斯克尔.吐拉洪 陈启龙[2] 包永星[1] 

机构地区：[1]新疆医科大学第一附属医院肿瘤中心,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院胰腺外科,新疆乌鲁木齐830054

出　　处：《中华肿瘤防治杂志》2013年第18期1436-1440,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：乌鲁木齐市科学技术计划(Y111310043;H111313001)

摘　　要：目的:分析胰腺癌的临床特征、治疗方式和生存状态,探讨胰腺癌预后因素。方法:回顾分析新疆医科大学第一附属医院2002-01-01-2011-12-31收治的353例维吾尔族和汉族胰腺癌患者的临床资料,应用Kaplan-Meier法计算生存率,并对可能影响患者预后的因素进行单因素分析(Log-rank检验),再用Cox比例风险模型对单因素分析有意义的因素进行多因素统计分析。结果:353例胰腺癌患者中位生存期为167d,0.5、1、2和5年生存率分别为47.1%、23.6%、11.4%和4.2%,其中维吾尔族和汉族患者的中位生存期分别为158和167d,0.5年生存率分别为46.7%和47.4%,1年生存率分别为24.8%和23.4%,2年生存率分别为12.8%和10.6%,差异无统计学意义,P>0.05。单因素分析显示,ECOG体力状况(ZPS)评分、临床分期、肿瘤部位及大小、有无手术及放化疗、治疗前血清癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原242(carbohydrate antigen 242,CA242)、糖类抗原199(carbohydrate antigen 199,CA199)水平与预后相关,P<0.001;多因素分析显示,ECOG体力状况(ZPS)评分、临床分期、肿瘤大小、有无手术及放化疗、治疗前血清CA242HE CA199水平可作为独立预后因素,P<0.05。结论:维吾尔族和汉族胰腺癌患者生存率无明显差异,且一般状况好、临床分期早、进行根治性手术及辅助治疗早、CA242及CA199水平低的患者预后较好。OBJECTIVE：To retrospectively analyse the clinical features of pancreatic cancer,treatment and survival condition in order to detect the prognostic factors of pancreatic cancer. METHODS： We retrospectively analyzed 353 cases of Uyghur and Han nationality pancreatic cancer clinical data from January 1,2002 to December 31,2011 in Xinjiang medi- cal university first affiliated hospital. We used Kaplan-Meier method for calculation of survival,and single factor analysis （Log-rank test） for these factors which could affect the prognosis of patients. We used Cox proportional risk model for multiple factors statistical analysis. RESULTS： Totally 353 cases of pancreatic cancer had a median survival of 167 days, and six months,l-,2- and 5-year survival rates were 47.1% ,23.6% ,11.4% and 4.2% respectively,and the Uighur pa- tients with a median survival of 158 days, six months, 1- and 2-year survival rates were 46.7 %, 24.8% and 12.8 % respec- tively,and the Han nationality patients with a median survival of 167 days, six months, 1- and 2-year survival rates were respectively 47.4%,23.4%and 10.6% ,and there were no statistical differences（P〈0.05）. Single factor analysis showed that ECOG physical condition （ZPS） score, clinical stage, tumor site and size, surgery and chemotherapy, serum careinoem- bryonic antigen （CEA） and carbohydrate antigen 242 （CA242） ,carbohydrate antigen 199 （CA199） levels before treatment associated with outcome （P〈0. 001） ; Multiple factors analysis showed that ECOG physical condition （ZPS） score, clini- cal stage, tumor size, surgery and chemotherapy,CA242 ,CA199 levels before treatment can be used as independent prog- nostic decision factors （P〈0.05）. CONCLUSIONS： The survival rates between uygur and Han patients with pancreatic cancer have no obvious difference. Pancreatic cancer patients with a better physical situation,earlier clinical stage, radicalsurgery,adequet adjuvant therapy and the lower level of CA242,CA199 can have a better prognosis.

关 键 词：胰腺肿瘤 人群 生存率 单因素分析 多因素分析 预后 

分 类 号：R735.9[医药卫生—肿瘤]