金属支架治疗胰腺癌合并梗阻性黄疸42例预后分析

Percutaneous metal stent implantation for the treatment of pancreatic cancer associated with obstructive jaundice: prognostic analysis of 42 patients

目的探讨经皮肝穿刺金属支架引流治疗不可切除胰腺癌合并梗阻性黄疸患者与预后相关的危险因素。方法回顾性分析2012年1月至2016年9月接受胆道支架植入术治疗的胰腺癌合并胆道梗阻患者42例,选择性别、年龄、肿瘤直径、TNM分期、血清CA19-9、总胆红素、胆管狭窄长度及术后是否化疗作为研究参数,评估影响该类患者生存期的相关危险因素。结果单因素Cox回归分析显示肿瘤直径、TNM分期、CA19-9及胆管狭窄长度4个因素是影响该类患者生存期的相关因素;多因素Cox回归分析显示TNM分期和CA19-9是影响该类患者生存期的重要因素。结论在对金属支架植入术治疗胰腺癌合并梗阻性黄疸时,TNM分期和CA19-9可能是影响患者生存期的相关因素,对评估该类患者预后有重要的参考意义。

Objective To discuss the risk factors related to the prognosis in patients with inoperable pancreatic cancer complicated by obstructive jaundice, who are treated with percutaneous metal stent implantation. Methods The clinical data of 42 patients with inoperable pancreatic cancer complicated by obstructive jaundice, who received biliary stent implantation during the period from January 2012 to September 2016, were retrospectively analyzed. The study parameters included gender, age, tumor size, TNM stage, serum CA19-9 level, total bilirubin （TBIL） level, the biliary stricture length and the use of postoperative chemotherapy. The possible related risk factors affecting the patient＇s survival time were statistically evaluated. Results Single-factor Cox regression analysis showed that the tumor size, TNM stage, CA19-9 level and the length of biliary stricture were the factors that had a correlation with the patient＇s survival time. Further multivariate Cox regression analysis revealed that TNM stage and CA19-9 level were the important factors related to patient＇s survival time. Conclusion In treating inoperable pancreatic cancer complicated by obstructive jaundice using percutaneous metal stent implantation therapy, TNM stage and CA19-9 level are the important factors that may affect the patient＇s survival time. These two parameters are of great value in estimating the patient＇s prognosis.