胰头癌根治术后患者预后相关因素分析  

Analysis of prognostic factors in patients with pancreatic head cancer after radical resection

作　　者：彭洋 孙韶龙[1] 王宝胜[1] 孔祥子 刘欢欢 肖刚[1] 王瑞[1] 金俊伊 Peng Yang;Sun Shaolong;Wang Baosheng;Kong Xiangzi;Liu Huanhuan;Xiao Gang;Wang Rui;Jin Junyi(Department of Pancreatic Endocrinology Surgery,Shengjing Hospital Affiliated to China Medical University,Liaoning Shenyang 110004,)

机构地区：[1]中国医科大学附属盛京医院胰腺内分泌外科,辽宁沈阳110004

出　　处：《现代肿瘤医学》2018年第24期3982-3985,共4页Journal of Modern Oncology

摘　　要：目的:探讨影响胰头癌根治性切除病人术后生存的相关因素。方法:回顾性分析2012年1月至2015年12月中国医科大学附属盛京医院111例行根治性手术切除的胰头癌患者的临床病理资料和随访资料。结果:111例患者术后中位生存时间12. 1个月,1、3、5年生存率分别为52. 3%、20. 6%、10. 8%。单因素分析显示,年龄、术前CA19-9水平、被膜外浸润、肿瘤大小、淋巴结转移、肿瘤分化程度、肿瘤分期、胰腺切缘、术后是否化疗为影响胰头癌预后的因素(P <0. 05)。COX多因素分析显示,术前CA19-9水平、肿瘤分化程度、淋巴结转移、被膜外浸润、肿瘤大小、术后是否化疗及胰腺切缘为胰头癌患者预后的独立影响因素(P<0. 05)。结论:肿瘤分化水平差、淋巴结转移、肿瘤直径大于等于4 cm、未达到R0切除的胰头癌患者预后较差,根治性手术术后联合化疗可明显延长胰头癌病人的生存时间。Objective： To explore the factors that affect the postoperative survival of pancreatic head cancer patients undergoing radical resection. Methods： The clinical pathological data and follow-up data of 111 pancreatic head cancer patients undergoing radical surgical resection from Shengjing Hospital of China Medical University January 2 0 1 2 to December 2 0 1 5 were examined retrospectively. Results： The median survival time of 111 patients was 12. 1 months. The 1-,3-,and 5-year survival rates were 52. 3%,20. 6% and 10. 8%,respectively. Univariate analysis showed that age,CA19-9 level,tumor size,lymph node metastasis,tumor differentiation,tumor stage,outer capsule invasion,pancreatic margin,and postoperative chemotherapy were the factors affecting the prognosis of pancreatic cancer（ P〈0. 05）. COX multivariate analysis showed that preoperative CA19-9 levels,tumor differentiation,outer capsule invasion,lymph node metastasis,tumor size,postoperative chemotherapy and pancreatic margin were independent predictors of prognosis in patients with pancreatic head cancer（ P〈0. 05）. Conclusion： The poor prognosis of tumor differentiation,lymph node metastasis,tumor diameter greater than or equal to 4 cm,poor prognosis of pancreatic head cancer patients who do not reach R0 resection,postoperative radical inflammatory combined with chemotherapy can significantly prolong the survival time of patients with pancreatic cancer.

关 键 词：胰头癌 预后 术后化疗 

分 类 号：R735.9[医药卫生—肿瘤]