胰头癌患者胰十二指肠切除术后复发的危险因素

Study on Risk Factors for Recurrence After Radical Pancreaticoduodenectomy of Pancreatic Head

目的 探讨胰头癌患者胰十二指肠切除术(PD)后复发的危险因素。方法 回顾性分析84例胰头癌患者临床资料,所有患者均顺利完成PD治疗,术后随访2年,根据患者复发情况分为复发组与未复发组。统计2组一般资料,包括性别、年龄、吸烟史、病灶直径、肿瘤标志125(CA125)水平、淋巴结转移、术后并发症、肿瘤分化程度、脉管转移、术后化疗,分析胰头癌患者PD术后复发的危险因素。结果 随访2年,84例胰头癌患者PD术后有30例复发,复发率为35.71%(30/84)。复发组CA125≥35 U/ml、淋巴结转移、肿瘤低分化、脉管转移、术后未化疗患者占比均高于未复发组,差异有统计学意义(P<0.05);Logistic回归分析:CA125≥35 U/ml、淋巴结转移、肿瘤低分化、脉管转移、术后未化疗是胰头癌患者PD术后复发的独立危险因素(P<0.05且OR≥1)。结论 胰头癌患者PD术后复发率较高,CA125≥35 U/ml、淋巴结转移、肿瘤低分化、脉管转移、术后未化疗是独立影响因素,临床需予以高度重视,以降低复发率,改善预后。

Objective To investigate the risk factors for recurrence after pancreaticoduodenectomy(PD) in patients with pancreatic head cancer.Methods The clinical data of 84 patients with pancreatic head cancer were retrospectively analyzed,and all patients successfully completed PD treatment and followed up for 2 years,which were divided into recurrence groups according to the recurrence of patients.General data of both groups,including gender,age,smoking history,lesion diameter,tumor marker 125(CA125) level,lymph node metastasis,postoperative complications,tumor differentiation,vasovascular metastasis,postoperative chemotherapy,analyzed risk factors for PD recurrence in patients with pancreatic head cancer.Results After 2 years of follow-up,84 pancreatic head cancer patients had 30 recurrence after PD,with a recurrence rate of 35.71%(30/84).A proportion of CA12535 U/ml,lymph node metastasis,low tumor differentiation,vascular metastasis,and no postoperative chemotherapy were statistically significant(P<0.05);Logistic regression analysis:CA12535 U/ml,lymph node metastasis,low tumor differentiation,vascular metastasis,and postoperative unchemotherapy were independent risk factors for PD recurrence in pancreatic head cancer(P<0.05 and OR 1).Conclusion The recurrence rate of pancreatic head cancer is high after PD,and CA12535 U/ml,lymph node metastasis,low tumor differentiation,vascular metastasis,and no postoperative chemotherapy are independent influencing factors,and clinical attention should be highly paid to reduce the recurrence rate and improve patient prognosis.