胰头癌患者术后预后评价及相关危险因素分析  

Evaluation of postoperative prognosis and related risk factors in patients with pancreatic head cancer

作　　者：徐俊明 张欣雪[1] 曹爽 刘喆 马军[1] 寇建涛[1] 贺强[1] Xu Junming;Zhang Xinxue;Cao Shuang;Liu Zhe;Ma Jun;Kou Jiantao;He Qiang(Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院肝胆外科,100020

出　　处：《中华普通外科学文献（电子版）》2021年第5期331-335,共5页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的评价胰头癌患者行根治性手术的预后情况,并分析影响预后的相关因素,为提高胰头癌患者生存率提供借鉴。方法回顾性分析首都医科大学附属北京朝阳医院2015年1月至2019年12月连续收治的167例可切除或交界可切除胰头癌患者的临床资料及随访情况,采用Kaplan-Meier法绘制生存曲线,生存率比较采用Log-rank检验,多因素Cox回归分析预后影响因素,以X-tile软件计算淋巴结参数的最佳截断值。结果167例患者均顺利完成手术,其中围手术期死亡2例(1.2%),其余患者均获随访。术后总体中位生存时间17个月,1、2、3年总体生存率分别为59.3%、36.5%、25.2%。肿瘤低分化(HR=1.708,95%CI:1.147~2.543)和淋巴结阳性率>0.1(HR=2.029,95%CI:1.069~3.853)是影响胰头癌患者预后的独立危险因素。结论胰头癌患者行根治性手术预后较好。肿瘤分化程度越低、淋巴结阳性率越高的胰头癌患者预后越差,淋巴结阳性率对于预后的预测优于单纯的淋巴结阳性数。Objective To evaluate the prognosis of patients with pancreatic head cancer undergoing radical surgery,and to analyze the related factors affecting the prognosis,in order to provide reference for improving the survival rate.Methods The clinical data and follow-up of 167 patients with resectable or borderline resectable pancreatic head cancer admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2015 to December 2019 were retrospectively analyzed.Kaplan-Meier method plotted the survival curve,Log-rank test was used for survival comparison,Multivariate Cox regression was used to analyze the prognostic factors,and the best cut-off value of lymph node parameters was calculated by X-tile software.Results All the patients successfully completed the operation,2 cases(1.2%)died during the perioperative period,and the other patients were followed up.The overall median survival time was 17 months.The 1-,2-and 3-year overall survival rates were 59.3%,36.5%and 25.2%respectively.Low tumor differentiation(HR=1.708,95%CI:1.147-2.543)and lymph node positive rate>0.1(HR=2.029,95%CI:1.069-3.853)were independent risk factors affecting the prognosis of patients with pancreatic head cancer.Conclusions The prognosis of patients with pancreatic head cancer undergoing radical surgery is better.The lower the degree of tumor differentiation and the higher the positive rate of lymph nodes,the worse the prognosis.Moreover,the predictive value of lymph node positive rate for prognosis is better than that of lymph node positive number.

关 键 词：胰头肿瘤 胰十二指肠切除术 TNM分期 淋巴结清扫 淋巴结阳性率 肿瘤分化 预后 

分 类 号：R735.9[医药卫生—肿瘤]