胰腺癌远处器官转移的影响因素及预后分析  

Analysis of Influencing Factors and Prognosis of Distant Organ Metastasis in Pancreatic Cancer

作　　者：南昇辰 石乔[2] 陶京 王卫星[1] NAN Sheng-chen;SHI Qiao;TAO Jing;WANG Wei-xing(Department of General Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Pancreas Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院普外科,武汉430060 [2]武汉大学人民医院胰腺外科,武汉430060

出　　处：《微循环学杂志》2023年第1期56-60,共5页Chinese Journal of Microcirculation

基　　金：国家自然科学基金(82170651)。

摘　　要：目的:探讨胰腺癌远处器官转移的影响因素及其预后分析。方法:2018-11-2021-11武汉大学人民医院140例确诊胰腺癌患者,以是否发生远处器官转移分为转移组(n=69)和非转移组(n=71)。根据两组患者基本资料、实验室检测指标、肿瘤标志物水平和瘤体特征的组间差异,应用单因素和多因素Logistic回归分析胰腺癌远处器官转移影响因素。应用单因素和多因素COX回归,分析相关因素对胰腺癌患者生存率的影响。通过受试者工作特征(ROC)曲线预测糖类抗原19-9(CA19-9)对胰腺癌转移的临床价值。结果:Logistic回归分析显示:白细胞计数(RR=1.454,95%CI:1.112-1.902,P<0.01)、中性粒细胞计数(RR=1.235,95%CI:1.093-1.328,P<0.05)和血清CA19-9水平(RR=7.16,95%CI:3.043-16.843,P<0.01)是影响胰腺癌器官远处转移的独立危险因素。COX回归分析显示:血清CA19-9水平是影响胰腺癌患者生存的独立危险因素(HR=1.882,95%CI:1.127-1.882,P<0.05)。ROC结果为CA19-9临界值为377.8U/ml,其曲线下面积(AUC)为0.79,检测胰腺癌转移的敏感度为0.826,特异度为0.676。结论:早期监测CA19-9及炎症指标,有利于早期干预胰腺癌远处器官转移,改善胰腺癌患者预后。Objective:To investigate the influencing factors of distant organ metastasis of pancreatic cancer and its prognostic analysis.Method:140 patients with confirmed pancreatic cancer from November 2018 to November 2021 were divided into metastatic group(n=69)and non-metastatic group(n=71)based on whether distant organ metastasis occurred.According to the differences between the two groups in personal information,laboratory test indexes,tumor marker levels and tumor characteristics between the two groups,univariate and multifactor logistic regressions were applied to analyze the factors influencing distant organ metastasis of pancreatic cancer.The effect of the relevant factors on the survival rate of pancreatic cancer patients was analyzed by univariate and multifactorial COX regression.The clinical value of CA19-9 on pancreatic cancer metastasis was predicted by subject operating characteristic curve(ROC).Results:Logistic regression analysis showed that leukocyte count(RR=1.454,95%CI:1.112-1.902,P<0.01),neutrophil count(RR=1.235,95%CI:1.093-1.328,P<0.05)and serum CA19-9 level(RR=7.16,95%CI:3.043-16.843,P<0.01)were independent risk factors affecting distant organs metastasis of pancreatic cancer.COX regression analysis showed that serum CA19-9 level played a critical role in the prognosis of pancreatic cancer patients(HR=1.882,95%CI:1.127-1.882,P<0.05).ROC results in dicated that the critical value of CA19-9is 377.8U/ml with an area under the curve(AUC)of 0.79and a sensitivity of 0.826and specificity of 0.676for detecting pancreatic cancer metastasis.Conclusion:Early monitoring of CA19-9and inflammation indicators is beneficial to reduce distant organ metastasis of pancreatic cancer and improve the prognosis of pancreatic cancer patients.

关 键 词：胰腺癌 器官转移 预后 糖类抗原19-9 

分 类 号：R735.9[医药卫生—肿瘤]