胰腺癌术后肝转移发生状况及影响因素分析

Incidence and influencing factors of liver metastasis after pancreatic cancer surgery

目的观察胰腺癌术后肝转移发生情况,并分析影响其发生的相关因素。方法抽取2020年2月至2022年1月河南省人民医院收治的92例需行胰十二指肠切除术或胰体尾切除术治疗的胰腺癌患者作为研究对象进行前瞻性研究。术后每3个月复诊1次,随访患者术后12个月内是否出现肝转移,根据随访结果将其分为转移组与未转移组。研究期间92例患者中因未完成后续随访、复诊脱落1例。使用自制患者基线资料表收集两组患者的基线资料,应用Logistic回归分析影响胰腺癌术后发生肝转移的相关因素。结果91例患者中发生肝转移35例(38.46%),纳入转移组;未出现肝转移56例(61.54%),纳入未转移组。转移组与未转移组乙肝病毒感染、合并脂肪肝、合并糖尿病、中性粒细胞与淋巴细胞比值(NLR)比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,乙肝病毒感染、合并糖尿病、NLR>4是影响胰腺癌术后出现肝转移的危险因素(OR>1,P<0.05),合并脂肪肝是影响胰腺癌术后出现肝转移的保护因素(OR<1,P<0.05)。结论胰腺癌患者术后1年内肝转移的发生风险较高,与合并乙肝病毒感染、脂肪肝、糖尿病、高NLR有关。

ObjectiveTo observe the incidence of liver metastases after pancreatic cancer surgery and to analyze the related factors affecting the occurrence.MethodsA total of 92 patients with pancreatic cancer who required for pancreatoduodenectomy or pancreaticotailectomy in Henan Provincial People’s Hospital from February 2020 to January 2022 were selected as research subjects for a prospective study.Follow-up visits were made every 3 months after operation,and patients were followed up to observe development of liver metastasis within 12 months after operation.According to the results of follow-up,the patients were divided into metastasis group and non-metastasis group.During the study period,1 of 92 patients dropped out due to incomplete follow-up and return visit.The self-made baseline data sheet was used to collect the general data from patients of the two groups.Logistic regression analysis was used to analyze the related factors affecting liver metastasis after operation for pancreatic cancer.ResultsAmong the 91 patients,35 cases(38.46%)had liver metastasis,and they were included in the metastasis group;56 cases(61.54%)had no liver metastasis,and they were included in the non-metastasis group.There were significant differences in hepatitis B virus infection,fatty liver,diabetes mellitus,and neutrophil-to-lymphocyte ratio(NLR)between the metastasis group and the non-metastasis group(P<0.05).Results of logistic regression analysis showed that hepatitis B virus infection,diabetes mellitus,and NLR>4 were the risk factors for liver metastasis after pancreatic cancer surgery(OR>1,P<0.05),and fatty liver was a protective factor against liver metastasis after pancreatic cancer surgery(OR<1,P<0.05).ConclusionsThe risk of liver metastasis in patients with pancreatic cancer within 1 year after surgery is higher,which is related to the hepatitis B virus infection,fatty liver,diabetes mellitus,and high NLR.