Ⅰ~Ⅱ期胰腺导管腺癌的临床病理特征及预后分析  

Analysis of clinicopathologic characteristics and prognosis of patients with stageⅠ~Ⅱpancreatic ductal adenocarcinoma

作　　者：曹经琳[1] 窦剑[1] 高庆军[1] 赵鑫[1] 崔自强 姜翀弋[2] 王巍 Cao Jinglin;DOU Jian;GAO Qingjun(Department of Hepatobiliary Surgery,The Third Hospital of Hebei Medical University,Hebei,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院肝胆外科,石家庄市050051 [2]复旦大学附属华东医院普通外科 [3]复旦大学附属肿瘤医院胰腺外科

出　　处：《河北医药》2021年第14期2126-2129,共4页Hebei Medical Journal

基　　金：河北省卫健委青年科技课题(编号:20190660)。

摘　　要：目的探讨早期胰腺导管腺癌(PDAC)根治术后患者临床病理特征与预后的关系,为临床诊治提供依据。方法回顾性分析2002年1月至2011年12月复旦大学附属华东医院的75例早期胰腺导管腺癌根治术后患者临床病理特征资料和预后。依据Kaplan-Meier法绘制生存曲线,生存期差异比较采用Log-rank检验。多因素Cox回归分析评估影响患者生存期的危险因素。结果75例早期PDAC患者中死亡63例,存活9例,失随访3例,总体生存时间为1.8~171.8个月,中位生存时间为(21.53±2.77)个月。1、2、3、5年总体生存率分别为73.3%、46.7%、33.3%和18.7%。单因素生存分析表明肿瘤大小、分化程度和手术切缘与预后相关。Kaplan-Meier显示PDAC肿瘤最大径≤2 cm者较>2 cm者术后生存中位时间长,高-中分化者较低分化者术后生存中位时间长,手术切缘阴性者较切缘阳性者术后生存中位时间长,差异有统计学意义(P<0.05)。多因素分析表明,肿瘤大小(P=0.038,HR=2.125,95%CI:1.043~4.330)、肿瘤分级(P=0.041,HR=1.371,95%CI:1.014~1.854)、手术切缘(P=0.018,HR=2.107,95%CI:1.138~3.901)是预后相关的独立危险因素。结论PDAC的肿瘤大小、分化程度和切缘可能影响患者预后,可为早期胰腺导管腺癌提供诊断依据。Objective To investigate the correlation between clinicopathologic characteristics and prognosis of patients with stageⅠ~Ⅱpancreatic ductal adenocarcinoma(PDAC).Methods The clinicopathological features and prognosis of 75 patients with early stage PDAC who were treated by radical resection in our hospital from January 2002 to December 2011 were retrospectively analyzed.Kaplan-Meier method was used to draw survival curve,and Log-rank test was used to compare survival time and multivariate Cox regression analysis was used to evaluate the risk factors for the survival duration of patients.Results At the 75 patients with PDAC,there were 63 death cases,9 survival cases and 3 cases were lost follow-up.The overall survival time was 1.8~171.8 months,and the median survival time was(21.53±77)months.The 1-year,2-year,3-year and 5-year overall survival rates were 73.3%,46.7%,33.3%,18.7%,respectively.Univariate survival analysis showed that tumor size,differentiation and surgical margin were associated with the prognosis of patients.Kaplan-Meier showed that the median survival time of patients with tumor diameter≤2cm was significantly longer than that of patients with PDAC tumor diameter>2cm(26.47m vs 20.47m,P<0.05),and the median survival time of patients with high medium differentiation was significantly longer than that of patients with low differentiation(25.20m vs 12.73m,P<0.05).Multivariate analysis showed that tumor size,differentiation degree and surgical margin were independent prognostic factors for PDAC.Conclusion The tumor size,differentiation degree and surgical margin of early PDAC may affect the prognosis of patients,which can provide diagnostic basis for early PDAC.

关 键 词：胰腺导管腺癌 术后 临床病理特征 预后 

分 类 号：R735.9[医药卫生—肿瘤]