胰腺癌肝转移患者预后相关因素分析

Prognostic Analysis of Pancreatic Carcinoma with Liver Metastasis

目的研究影响胰腺癌肝转移患者生存的临床病理相关因素。方法随访41例胰腺癌肝转移患者,选择可能会影响胰腺癌肝转移患者预后的因素:年龄、性别、血型、病程、首发症状、肿瘤大体、肿瘤组织类型、病理分级、淋巴结转移、术前合并症、伴发病、手术性质、手术方式、肝转移灶部位、肝转移灶个数、肝转移直径、肝转移处理方式、术后化疗方案、术前血HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc、CEA、CA-125、CA19-9、术前肝功能,单因素分析各因素对生存率的影响。多因素分析用COX比例风险模型。结果胰腺癌肝转移患者的中位生存周期为8.0个月。单因素分析提示患者的年龄、病程、肝转移灶部位、抗-HBe、抗-HBc、直接胆红素、间接胆红素、直/总胆红素、总蛋白、球蛋白、白/球蛋白是影响患者预后的主要因素,多因素分析提示患者的年龄、病程、肝转移病灶部位、抗-HBe、直接胆红素、直/总胆红素、总蛋白、球蛋白、白/球蛋白影响患者的预后。结论患者的年龄、病程、肝转移病灶部位、抗-HBe、直接胆红素、直/总胆红素、总蛋白、球蛋白、白/球蛋白是影响胰腺癌肝转移患者预后的主要因素。

Objective To explore clinical pathologic factors effect survival time of pancreatic carcinoma with liver metastasis. Methods 41 patients of pancreatic cancer with liver metastasis were reviewed. The follow factors were selected ： age, gender, course of disease, symptom, tumor general view, tumor histotype, pathologic grade, infiltration, lymphatic metastasis, complication, operation, operation method, the position, number and the maximum diameter of liver metastasis, time of liver metastasis appeared, treatment of metastasis, chemotherapy after operation, HBsAg, anti-HBs, HBeAg,anti-HBe, anti-HBc, CEA, CA-125, CA19-9 and liver function. Univariate analysis with Kaplan-Meier methods and multivariate analysis with Cox regression model were carried out. Results The median survival time of pancreatic cancer with liver metastases patients was 8.0 months. Univariate analysis showed ages, course of diseases,the position of liver metastasis, anti-HBe, anti-HBc, DBil, IBil, DBil/TBil, total protein, globlin, A/G were the main prognostic factors. Multi-analysis results showed ages, course of diseases, the position of liver metastasis, anti-HBe, DBil, DBil/TBil, total protein,globlin,A/G were the main prognostic factors. Conclusion Age,course of disease,the position of liver metastasis, anti-HBe,DBil,DBil/TBil,total protein,globhn,A/G are the main prognostic factors.