十二指肠乳头癌行胰十二指肠切除术患者预后相关因素分析

Prognostic factors of survival for patients with duodenal papilla carcinoma after pancreaticoduodenectomy

目的探讨影响十二指肠乳头癌行胰十二指肠切除术患者预后的临床及病理因素。方法回顾性分析上海交通大学医学院附属仁济医院2010年1月至2017年12月行胰十二指肠切除术的98例十二指肠乳头癌患者的临床资料。结果80例患者获得随访,术后1、3、5年生存率分别为89.9%、72.4%、66.6%。单因素分析显示肿瘤大小、T分期、N分期、TNM分期、组织分化程度与术后生存显著相关(均P V0.05)。多因素分析显示肿瘤大小、N分期、TNM分期、组织分化程度是影响患者预后的独立因素(均P<0.05)。结论肿瘤大小、N分期、TNM分期及组织分化程度是影响十二指肠乳头癌行胰十二指肠切除患者预后的独立危险因素,早期诊断、早期治疗和根治性切除是提高十二指肠乳头癌预后的关键。

Objective To investigate the prognostic factors of survival for patients with duodenal papilla carcinoma(DPC)after pancreaticoduodenectomy.Methods 98 DPC patients undergoing pancreaticoduodenectomy with follow-up from Jan 2010 to Dec 2017 at Renji Hospital,School of Medicine,Shanghai Jiao Tong University were analyzed retrospectively.Results 80 Cases were followed up.The 1,3,and 5 year survival rates of 80 patients were 89.9%,72.4%,and 66.6%,respectively.Univariate analysis showed tumor size,T stage,N stage,TNM stage,tissue differentiation degree were related to postoperative survival(all P<0.05).Multivariate analysis showed that tumor size,N stage,TNM stage,and tissue differentiation degree were independent factors influencing postoperative prognosis(all P<0.05).Conclusions Tumor size,N stage,TNM stage and tumor tissue differentiation degree were independent factors influencing the prognosis of DPC after pancreaticoduodenectomy,suggesting that early diagnosis,early treatment and radical resection were the key to improve the postoperative prognosis of DPC.