胰十二指肠切除术治疗十二指肠乳头癌—肿瘤大小和淋巴结转移影响术后长期生存  

Pancreaticoduodenectomy for duodenal papillary carcinoma:tumor size and lymph node metastasis affect long-term survival

作　　者：崔笑[1] 郭子成 薛鸿 魏昇 刘永凡 耿小平[2] 黄艳[3] 侯辉[1] Cui Xiao;Guo Zicheng;Xue Hong;Wei Sheng;Liu Yongfan;Geng Xiaoping;Huang Yan;Hou Hui(Department of General Surgery,the Second Hospital of Anhui Medical University,Heifei 230000,China;Department of General Surgery,the First Hospital of Anhui Medical University,Heifei 230000,China;School of Pharmacy,Anhui Medical University,Heifei 230000,China)

机构地区：[1]安徽医科大学第二附属医院普外科,合肥230000 [2]安徽医科大学第一附属医院普外科,合肥230000 [3]安徽医科大学药学院,合肥230000

出　　处：《中华普通外科杂志》2024年第9期686-691,共6页Chinese Journal of General Surgery

基　　金：国家自然科学基金(82370591);安徽省科技攻关计划项目(202204295107020030);安徽医科大学校科研基金(2022xkj182);安徽医科大学第二附属医院转化医学研究科研基金(2022ZHYJ06);藏医药管理局局级科研课题及标准化研究项目(JJKT2023008)。

摘　　要：目的探讨影响十二指肠乳头癌行胰十二指肠切除术后长期生存的临床病理因素。方法回顾性分析2015年1月至2021年12月在安徽医科大学第一附属医院和安徽医科大学第二附属医院接受胰十二指肠切除术治疗的十二指肠乳头癌患者的临床和病理资料。结果所有73例患者均获得术后随访,中位随访时间60个月。COX比例风险模型多因素分析结果显示淋巴结转移阳性、肿瘤大小超过2.5 cm是影响总生存和无复发生存的共同独立危险因素。20例患者术后病理证实淋巴结转移,Logistic回归模型多因素分析结果显示吸烟、肿瘤突破浆膜层和肿瘤低分化是影响淋巴结转移的独立危险因素。结论肿瘤大小超过2.5 cm以及淋巴结转移阳性与十二指肠乳头癌较差的预后有关,吸烟、肿瘤突破浆膜层和肿瘤低分化是淋巴结转移阳性的预测因素。Objective To investigate the clinicopathological factors affecting the long-term survival of patients with duodenal papillary carcinoma(DPC)after pancreaticoduodenectomy(PD).Methods The clinicopathological and follow-up data of patients with DPC who underwent PD at the First Affiliated Hospital of Anhui Medical University and the Second Hospital of Anhui Medical University from Jan 2015 to Dec 2021 were retrospectively analyzed.Results All 73 cases have been followed-up.The median follow-up time was 60 months.Multivariate analysis of COX proportional risk model showed that positive lymph node metastasis and tumor size over 2.5 cm were common independent risk factors for OS and DFS.Lymph node metastasis was confirmed pathologically in 20 patients.Multivariate analysis results of Logistic regression model showed that smoking,tumor breaking through the serous layer and tumor low differentiation were independent risk factors for lymph node metastasis.Conclusions Poor prognosis was associated with tumors that were larger than 2.5 cm,and with lymph node metastases.Preoperative smoking history,tumor breaking through the serous layer and low tumor differentiation were the predictors of positive lymph node metastasis.

关 键 词：胰十二指肠切除术 预后 十二指肠乳头癌 淋巴结转移 

分 类 号：R735.31[医药卫生—肿瘤]