胰腺癌切除术后预后相关因素的临床分析

Clinical analysis of prognostic factors in the postoperative pancreatic cancer

目的通过回顾性分析78例胰腺癌手术切除患者的生存情况，探讨胰腺癌切除术后影响患者生存的临床及病理因素。方法将2005-2008年间哈尔滨医科大学附属第三医院收治的78例胰腺癌手术切除病例的临床资料进行回顾性分析，用Kaplan—Meier法对可能影响预后的指标：年龄、性别、血糖、血型、疼痛症状、术前CA19—9、肿瘤部位、淋巴结转移、临床分期及辅助治疗进行单因素分析，并用Cox比例风险模型对单因素分析结果中的阳性指标进行多因素分析。结果单因素分析显示术前CA19—9、术后病理淋巴结转移情况、辅助治疗、临床分期和伴有疼痛症状是影响术后胰腺癌患者预后的因素，有统计学意义（P〈0．05）。而年龄、性别、血型、血糖、肿瘤部位与胰腺癌术后生存期无关，差异无统计学意义（P〉0．05）；多因素分析显示术前CA19—9水平、术后病理淋巴结转移情况、临床分期是影响胰腺癌切除术后患者的独立预后因素（P〈0．05）。结论胰腺癌切除术后接受辅助治疗会使患者在生存期方面获益，但不是影响预后的独立因素；术前CA19—9水平、术后病理淋巴结转移情况、临床分期为影响胰腺癌术后患者预后的独立因素。

Objective To discuss the prognosis factors of the postoperative pancreatic cancer. Methods We collected 78 patients with pancreatic cancer resection from the Third Affiliated Hospitial of Harbin Medical University during 2005-2008 in this retrospective study, and analyzed the factors including：age, gender, glucose, blood type, symptom of pain, preoperative CA19 - 9, tumor＇ s position, lymph node metastasis, clinical stage,adjuvant therapy with Kaplan - Meier of univariate analysis and Cox proportional hazards model analysis of the positive factors in the multivariate analysis. Results Univariate analysis showed that preoperative CA19 -9 〉 37 U/mL,lymph node metastasis, without adjuvant therapy, clinical stage Ⅲ and with pain symptom would be bad for survival （P 〈 0.05 ）. Age, gender, glucose, ABO blood type and tumor＇s position did not influence on sur-vival （P 〉 0.05 ）. Multivariate analysis showed that preoperative CA19 -9 level, pathological lymph node metasta-sis and clinical stage were the independent prognostic factors for postoperative pancreatic cancer. Conculusion Adjuvant therapy will be benefit for the survival, but not the independent prognostic factor. Preoperative CA19 -9 level, pathological lymph node metastasis and clinical stage are independent prognostic factors for postoperative pancreatic cancer.