胰腺癌预后的影响因素分析(附71例报道)

Influence Factors of Pancreatic Cancer:Analysis of 71 Cases

目的探索胰腺癌预后的影响因素。方法回顾性分析2010年1月至2014年12月期间兰州大学第一医院普外二科收治的71例胰腺癌患者的临床资料，探索胰腺癌预后的影响因素。结果71例患者中有60例患者获访，随访率达84．5％；随访时间5-36个月，中位数为16个月；其1、2及3年累积生存率分别为60．6％、23．9％及1．4％。单因素分析结果显示，性别（P=0．043）、淋巴结转移（P=0．002）、远处转移（P=0．000）、TNM分期（P=0．000）及胰周侵犯（P=0．000）均与胰腺癌的预后有关，女性患者、存在淋巴结转移、存在远处转移、TNM分期越晚及存在胰周侵犯者的预后较差；Cox比例风险回归模型结果显示：远处转移（P=0．047）、TNM分期（P=0．002）及胰周侵犯（P=0．016）均是胰腺癌预后的影响因素，存在远处转移、TNM分期越晚及存在胰周侵犯者的预后较差。结论远处转移、TNM分期及胰周侵犯为胰腺癌患者预后的独立影响因素。

Objective To explore the prognostic factors of pancreatic cancer. Methods Clinical data of 71 patients of pancreatic cancer who treated in The First Hospital of Lanzhou University from January 2010 to December 2014 were retrospectively collected to analyze the prognostic factors of pancreatic cancer. Results Sixty patients of the 71 patients were followed up for 5-36 months, with the median time of 16 months, and the 1, 2, and 3-year cumulative survival rates were 60.6%, 23.9%, and 1.4% respectively. Univariate analysis results showed that, gender （P=0.043）, lymph node metastasis （P=0.002）, distant metastasis （P=0.000）, TNM staging （P=0.000）, and peripancreatic invasion （P=0.000） were correlated with the prognosis of pancreatic cancer, that female patients, patients with the presence of lymph node metastasis, distant metastasis, later TNM staging, and peripancreatic invasion had worse prognosis. Cox proportional hazard model results showed that, distant metastasis （P=0.047）, TNM staging （P=0.002）, and peripancreatic invasion （P=0.016） were prognostic factors of pancreatic cancer, patients with the presence of distant metastasis, later TNM staging, and peripancreatic invasion had poor prognosis. Conclusion Distant metastasis, TNM staging, and peripancreatic invasion were independent prognostic factors of pancreatic cancer.