壶腹癌胰十二指肠切除术后患者预后的影响因素分析

Prognostic Factors of Patients with Ampullary Carcinoma after Pancreatoduodenectomy

目的分析壶腹癌胰十二指肠切除术后患者预后的影响因素。方法选取壶腹癌患者120例,均行胰十二指肠切除术,统计3年生存率,收集生存者和死亡者性别、年龄、分化程度、TNM分期、肿瘤大小、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)水平等临床资料,分析影响预后的相关因素。结果120例患者均获得有效随访,3年生存率为65.00%(78/120)。性别、年龄、分化程度与壶腹癌患者胰十二指肠切除术后3年生存无明显相关(P>0.05),肿瘤大小、有无血管侵犯、NLR水平、PLR水平、有无淋巴结转移和有无术后辅助治疗是壶腹癌患者胰十二指肠切除术后3年生存的影响因素(P<0.05);logistic回归分析显示,TNM分期高、肿瘤≥5 cm、存在血管侵犯、NLR高表达、PLR高表达、存在淋巴结转移、术后无辅助治疗是影响壶腹癌患者胰十二指肠切除术后3年生存的危险因素(P<0.05)。结论TNM分期高、肿瘤病灶大、NLR和PLR高表达、合并血管侵犯、伴有淋巴结转移及术后未实施辅助治疗是壶腹癌患者胰十二指肠切除术后3年生存的危险因素,临床应据此进行实施干预措施,延长患者术后生存期,提高预后效果。

Objective To analyze the prognostic factors of ampullary carcinoma after pancreatoduodenectomy.Methods120 patients with ampullary carcinoma were selected,all of them underwent pancreatoduodenectomy,and the 3-year survival rate was calculated.The clinical data such as gender,age,differentiation degree,TNM stage,tumor size,neutrophil/lymphocyte(NLR)and platelet/lymphocyte(PLR)levels of the survivors and the dead were collected,and the related factors affecting the prognosis were analyzed.Results All 120 patients were followed up effectively.The 3-year survival rate was 65.00%(78/120).There was no significant correlation between gender,age,degree of differentiation and 3-year survival after pancreatoduodenectomy(P>0.05).Tumor size,vascular invasion,NLR level,PLR level,lymph node metastasis and postoperative adjuvant therapy were the influencing factors of 3-year survival after pancreatoduodenectomy(P<0.05).Logistic regression analysis showed that high TNM stage,tumor≥5cm,vascular invasion,high expression of NLR,high expression of PLR,lymph node metastasis and no adjuvant therapy were risk factors for 3-year survival of ampullary carcinoma patients after pancreatoduodenectomy(P<0.05).Conclusion High TNM stage,large tumor focus,high expression of NLR and PLR,vascular invasion,lymph node metastasis and no adjuvant therapy are risk factors for 3-year survival of patients with ampullary carcinoma after pancreatoduodenectomy.Clinical intervention measures should be implemented accordingly to prolong the survival period and improve the prognosis.