胰腺癌术后复发的相关危险因素分析

Analysis of related risk factors for postoperative recurrence of pancreatic cancer

目的:探讨胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)患者术后复发的相关危险因素。方法:回顾性分析2016年12月至2019年12月在兰州大学第一医院普外科因PDAC行手术治疗的89例患者临床资料。根据术后是否复发分为复发组(n=57)和未复发组(n=32)。通过Logistic回归分析,评估PDAC患者术后复发的相关危险因素及可能的独立影响因素。结果:分析发现复发组的男性患者和合并高血压病史的例数明显高于未复发组,差异有统计学意义(P<0.05)。复发组和未复发组患者的单核细胞计数(monocyte count,MO)、嗜碱性粒细胞计数(basophil count,BA)、碱性磷酸酶(alkaline phosphatase,ALP)、γ-谷氨酰基转移酶(γ-glutamyl transferase,GGT)差异有统计学意义(P<0.05),且两组在肿瘤切缘、肿瘤分化程度、淋巴结转移数目、临床分期方面的比较存在统计学差异(P<0.05)。Logistic多因素回归分析结果显示,影响PDAC患者术后复发的独立危险因素有高血压、MO、BA、GGT、肿瘤分化程度、淋巴结转移数目、临床分期(P<0.05)。结论:影响PDAC患者术后复发的独立危险因素有高血压、MO、BA、GGT、肿瘤分化程度、淋巴结转移数目、临床分期,对高危患者尽可能地控制血压、改善机体免疫功能等,可降低术后的复发率,改善患者的长期预后。

Objective:To explore the risk factors of postoperative recurrence in patients with pancreatic ductal adenocarcinoma(PDAC).Methods:A retrospective trail enrolled clinical data of 89 patients who underwent surgery for PDAC in department of general surgery of the First Hospital of Lanzhou University from December 2016 to December 2019.According to whether recurrence,patients were divided into recurrence group(n=57)and non-recurrence group(n=32).Through Logistic regression analysis,the risk factors for postoperative recurrence of PDAC patients and possible independent influencing factors were evaluated.Results:This study found that cases of male patients and history of hypertension in recurrence group were significantly higher than that in non-recurrence group(P<0.05).The monocyte count(MO),basophil count(BA),alkaline phosphatase(ALP),γ-glutamyl transferase(GGT)were significantly different between recurrence group and non-recurrence group(P<0.05).The surgical margin,degree of differentiation,number of lymph node metastases and clinical stage were significantly different between the recurrence group and the non-recurrence group(P<0.05).The results of multivariate Logistic regression showed the independent risk factors for postoperative recurrence of PDAC patients included hypertension,MO,BA,GGT,degree of differentiation,number of lymph node metastases,clinical stage(P<0.05).Conclusion:The risk factors of the postoperative recurrence of PDAC patients included hypertension,MO,BA,GGT,degree of differentiation,number of lymph node metastases,clinical stage.In order to reduce the postoperativere currence rate for PDAC patients and improve the long-term prognosis of PDAC patients,we should control the blood pressure and improve the immune function of high-risk PDAC patients as much as possible.