195例早期胰腺癌手术方式与生存率的关系  

Analysis on Surgical Methods Associated with Survival Rate of Patients with Early Pancreatic Cancer

作　　者：陈祺[1] 李东恩[1] 姜建帅[1] 

机构地区：[1]浙江省宁波市第一医院肝胆胰外科,宁波315000

出　　处：《中国中西医结合外科杂志》2016年第1期3-5,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的：分析早期胰腺癌手术方式和生存率的关系。方法：应用Kaplan-Meier法、Log-rank检验和Cox多元回归模型,分析195例早期胰腺癌患者性别、年龄、TNM分期、手术方式与总体生存率及肿瘤相关死亡的关系。结果：195例中位生存期为13.27个月（398天）,1-5年总体生存率为32.58%、23.27%、18.28%、18.28%和18.28%;单因素分析结果表明,不同组别中位的生存期比较,TNM II期（306 d）低于I期（881 d,P〈0.001）;姑息手术组（267 d）低于根治组（460 d,P=0.006）;诊断时年龄〉65岁组（296 d）低于≤65岁组（461 d,P=0.006）;未发现总体生存率与性别、城乡户籍有统计学关联（P=0.602,0.694）;多因素Cox回归模型分析结果表明,除诊断高年龄和TNM高分期外,姑息术是总体生存率（P=0.004）及肿瘤相关生存率（P=0.004）降低的独立危险因素。结论：早期胰腺癌治疗应尽可能选择根治手术,有利于提高患者生存率。ObjectiveTo analyze the relationship of surgical conditions associated with the survival of pa-tients with early pancreatic cancer for providing a reference for home care and predicting the patients＇ progno-sis.MethodsSubsets of 195 early pancreatic cancer patients collected were used to screen the potential riskfactors for survival, such as age, TNM stage, gender and surgical methods. The patients＇ survival in differentgroups was analyzed by Kaplan-Meier method, Log-rank test and Cox regression analysis.Results In the195 patients with early pancreatic cancer, the median survival time was 13.27 months（398 days）, and 1 to 5years survival rates were 32.58%, 23.27%, 18.28%, 18.28% and 18.28%. Comparing with the different groups＇ median survival time, the patients with II stage were 306 days, lower than the 881 days of those with I stage（χ2=18.442,P〈 0.001）, the patients with palliative resection were 267 days, lower than the 460 days of those withradical excision（χ2=7.607,P = 0.006）, and the patients over 65 years old were 296 days, lower than those young-er ones whose median survival time were 461 days. There was no statistical significance in gender and address（χ2=0.271, 0.155, P =0.602,0.694）. Cox multivariate regression analysis showed that, including elder and highTNM stage, patients with palliative resection had significantly lower cancer-specific survival（hazard ratio（HR）=1.755,95 % confidence interval（CI）： 1.196-2.575） and all-cause survival（HR=1.752,95 % CI： 1.190-2.579）（P = 0.004）.ConclusionRadical excision is an effective method to obtain a preferable survival for the pa-tients with early pancreatic cancer.

关 键 词：胰腺癌 早期 手术方式 生存率 

分 类 号：R735.9[医药卫生—肿瘤]