壶腹周围癌患者根治性切除术后肿瘤复发影响因素分析  

Analysis of influencing factors of tumor recurrence in patients with periampullary carcinoma after radical resection

作　　者：陈文菊 罗会芹 吴书胜[1,2] 何义富 CHEN Wen-ju;LUO Hui-qin;WU Shu-sheng;HE Yi-fu(The First Affiliated hospital of USTC,Division of Life Sciences and Medice,University of Science and Technology of China,Hefei 230031,China;Department of First Ward of Gastrointestinal Cancer,Anhui Cancer Hospital,Hefei 230031,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)西区,安徽合肥230031 [2]安徽省肿瘤医院消化道肿瘤内科一病区,安徽合肥230031

出　　处：《临床军医杂志》2024年第12期1231-1234,共4页Clinical Journal of Medical Officers

基　　金：合肥市关键共性技术研发和重大科技成果工程化立项项目(2021YL005);2021年安徽省重点研究与开发计划第一批立项项目(202104j07020044)。

摘　　要：目的探讨壶腹周围癌患者根治性切除术后肿瘤复发的影响因素。方法选取安徽省肿瘤医院自2017年1月至2024年4月收治的261例壶腹周围癌患者为研究对象。所有患者均接受根治性切除术。根据随访期间是否出现术后肿瘤复发将患者分为未复发组(n=165)与复发组(n=96)。记录并比较两组患者的肿瘤特征、实验室检验指标、脂代谢指标及肿瘤标志物。采用多因素Logistic回归分析筛选壶腹周围癌患者根治性切除术后肿瘤复发的影响因素。结果两组患者分化程度比较,差异均有统计学意义(P<0.05);复发组患者神经侵犯与脉管癌栓比例均高于未复发组,差异均有统计学意义(P<0.05)。两组患者实验室检验指标与脂代谢指标比较,差异均无统计学意义(P>0.05)。复发组患者血清癌胚抗原(CEA)与糖类抗原199(CA199)水平均高于未复发组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,CEA、CA199、脉管癌栓、神经侵犯均为壶腹周围癌患者根治性切除术后肿瘤复发的影响因素(P<0.05)。结论肿瘤标志物CEA、CA199水平较高,存在脉管癌栓和神经侵犯均为壶腹周围癌患者根治性切除术后肿瘤复发的独立危险因素,临床中应密切关注,并制定个体化的辅助治疗方案,以降低肿瘤复发风险,改善患者预后。Objective To investigate the influencing factors of tumor recurrence in patients with periampullary carcinoma after radical resection.Methods A total of 261 patients with periampullary carcinoma admitted to Anhui Cancer Hospital from January 2017 to April 2024 were selected as the study objects.All patients underwent radical resection.Patients were divided into non-recurrence group(n=165)and recurrence group(n=96)according to whether the tumor recurred during follow-up.The tumor characteristics,laboratory test indexes,lipid metabolism indexes and tumor markers of the two groups were recorded and compared.Multivariate Logistic regression analysis was used to screen the influencing factors of tumor recurrence in patients with periampullary carcinoma after radical resection.Results There was statistical significance in the differentiation degree between two groups(P<0.05).The proportion of nerve invasion and vascular cancer thrombus in recurrent group was higher than that in non-recurrence group,and the differences were statistically significant(P<0.05).There was no significant difference in laboratory test indexes and lipid metabolism indexes between two groups(P>0.05).The levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)in patients with recurrence were higher than those in non-recurrence group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that CEA,CA199,vascular cancer thrombus and nerve invasion were all factors affecting tumor recurrence after radical resection in periampullary carcinoma patients(P<0.05).Conclusion The level of tumor markers CEA and CA199 is high,and vascular cancer embolus and nerve invasion are independent risk factors for tumor recurrence in patients with periampullary cancer after radical resection.In clinical practice,close attention should be paid and individualized adjuvant therapy should be developed to reduce the risk of tumor recurrence and improve the prognosis of patients.

关 键 词：壶腹周围癌 根治性切除术 肿瘤复发 影响因素 

分 类 号：R735[医药卫生—肿瘤]