胰腺癌肝转移患者的临床病理特征及预后的影响因素分析  

Clinicopathological characteristics and prognostic factors analysis of pancreatic cancer patients with liver metastasis

作　　者：郝智彬 彭小波 湛先保 Hao Zhibin;Peng Xiaobo;Zhan Xianbao(Department of Oncology,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院肿瘤科,上海200433

出　　处：《中华胰腺病杂志》2023年第2期134-138,共5页Chinese Journal of Pancreatology

基　　金：国家自然科学基金(81672892、82072707);长海医院234学科建设项目(2019YXK019、2020YXK029)。

摘　　要：目的探讨胰腺癌伴肝转移患者的临床病理特征及预后的影响因素。方法回顾性分析2012年7月至2016年6月间海军军医大学第一附属医院肿瘤科收治的67例初治胰腺癌伴肝转移患者的临床资料,分析患者生存时间与年龄、性别、肿瘤位置、体力活动状态评分、肿瘤标志物、远处转移器官数目、原发灶放疗情况、一线化疗方案、接受一线化疗周期数和肝转移灶行肝动脉化疗栓塞术(TACE)等临床病理特征的关系。采用Kaplan-Meier法绘制生存曲线,采用单因素和多因素COX回归模型分析胰腺癌伴肝转移患者的独立预后危险因素。结果随访至2018年12月31日,67例胰腺癌伴肝转移患者均已死亡。单因素分析结果显示,肿瘤标志物阳性、远处转移器官数目≥2个、一线化疗周期数≤2次、原发灶未接受放疗和肝转移灶未行TACE治疗患者的中位生存时间显著短于肿瘤标志物阴性、远处转移器官数目1个、一线化疗周期数≥3次,原发灶接受放疗和肝转移灶行TACE治疗的患者,差异有统计学意义(P值均<0.05);多因素分析结果显示,肿瘤标志物阳性(HR=0.567,95%CI 0.332~0.954,P=0.031)、远处转移器官数目≥2个(HR=0.581,95%CI 0.353~0.977,P=0.039)、一线化疗周期数≤2次(HR=1.890,95%CI 1.155~3.121,P=0.013)和原发灶未放疗(HR=0.414,95%CI 0.231~0.732,P=0.002)为影响胰腺癌伴肝转移患者预后的相关危险因素。结论胰腺癌伴肝转移患者预后受多因素影响,其中肿瘤标志物阳性、远处转移器官数目多、原发灶未放疗和一线化疗周期数少为胰腺癌伴肝转移的独立预后危险因素。Objective To investigate the clinicopathological characteristics and prognostic factors of pancreatic cancer patients with liver metastasis.Methods The clinical data of 67 pancreatic cancer patients with liver metastases who received first treatment in Department of Oncology of the First Affiliated Hospital of Naval Medical University between July 2012 and June 2016 were retrospectively analyzed.The relationship between patient survival time and the clinicopathological characteristics including patients'age,gender,tumor location,physical activity status score,tumor markers,number of distant metastatic organs,radiotherapy at the primary site,first-line chemotherapy regimen,number of cycles of first-line chemotherapy received,and liver metastases undergoing transcatheter arterial chemoembolization(TACE)was analyzed.Kaplan-Meier curves were plotted to reveal survival time in pancreatic cancer patients with liver metastases,and univariate and multifactorial COX proportional risk regression models were used to analyze independent prognostic risk factors for pancreatic cancer patients with liver metastases.Results All patients were followed up until December 31,2018,and all 67 patients died.The results of univariate analysis showed that patients with positive tumor marker,number of distant metastatic organs≥2,number of cycles of first-line chemotherapy≤2,no radiotherapy to the primary site and no TACE had shorter survival than those with negative tumor marker,one distant metastatic organ,number of cycles of first-line chemotherapy≥3,with radiotherapy to the primary site and TACE,and all the differences were statistically significant(all P values<0.05).The results of multifactorial analysis showed that positive tumor markers(HR=0.567,95%CI 0.332-0.954,P=0.031),number of distant metastatic organs≥2(HR=0.581,95%CI 0.353-0.977,P=0.039),number of first-line chemotherapy cycles≤2(HR=1.890,95%CI 1.155-3.121,P=0.013)and primary foci without radiotherapy(HR=0.414,95%CI 0.231-0.732,P=0.002)were the independent prognost

关 键 词：胰腺肿瘤 肝转移 疾病特征 综合疗法 预后 

分 类 号：R735.9[医药卫生—肿瘤]