老年胰腺癌临床病理特征及预后相关因素分析

Analysis of clinicopathological characteristics and prognostic factors of pancreatic cancer in the elderly

[目的]研究老年胰腺癌患者临床病理特征及预后的影响因素,以期为临床诊断及治疗提供参考。[方法]回顾性分析278例老年胰腺癌患者的临床资料,包括性别、年龄、分化程度、肿瘤位置、是否合并基础疾病、肿瘤最大径、脉管瘤栓、胰周侵犯、临床分期、放化疗、淋巴结转移及远处转移。所有研究对象均经随访评估预后,根据预后情况将患者分为生存组及死亡组。应用单因素分析影响2组老年胰腺癌患者预后的差异因素,并采用多因素Logistic分析对上述有差异的统计学资料进行进一步回归分析。[结果]278例老年胰腺癌患者随访1年,生存组192例,死亡组86例,1年生存率为69.06%。单因素分析显示,2组患者在分化程度、年龄、胰周侵犯、肿瘤最大径、临床分期、淋巴结转移及远处转移上比较差异有统计学意义(P<0.05),而2组患者在肿瘤位置、性别、合并基础疾病及是否放化疗上比较差异无统计学意义(P>0.05)。经多因素Logistic回归分析结果显示,低分化、年龄>75岁、肿瘤最大径>5 cm、胰周侵犯、Ⅱ~Ⅳ期、淋巴结转移及远处转移为影响老年胰腺癌预后的独立危险因素。[结论]老年胰腺癌患者预后受分化程度、年龄、肿瘤最大径、胰周侵犯、临床分期、淋巴结转移及远处转移等多种因素影响,临床上可重点关注具有此类特征的患者。

[Objective]To study the clinicopathological characteristics and prognostic factors in elderly patients with pancreatic cancer,in order to provide references for clinical diagnosis and treatment.[Methods]The clinical data of 278 elderly patients with pancreatic cancer were retrospectively analyzed,including gender,age,degree of differentiation,tumor location,underlying disease,maximum tumor diameter,and pulse tumor thrombus,peripancreatic invasion,clinical staging,radiotherapy and chemotherapy,lymph node metastasis and distant metastasis.All study subjects were followed up,and the patients were divided into survival group and death group according to the prognosis.Univariate analysis was used to analyze the different factors affecting the prognosis of the two groups of elderly patients with pancreatic cancer,and the multivariate Logistic analysis was used to further regression analysis of the above-mentioned statistical data.[Results]There were 192 cases in the survival group and 86 cases in the death group.The 1-year survival rate was 69.06%.Univariate analysis showed that the two groups of patients had significant statistical differences in differentiation,age,peripancreatic invasion,maximum tumor diameter,clinical stage,lymph node metastasis and distant metastasis(P<0.05).There were no significant differences in tumor location,gender,combined underlying diseases,and whether radiotherapy or chemotherapy were undergone(P>0.05).The results of multivariate Logistic regression analysis showed that poorly differentiated,age>75 years old,tumor diameter>5 cm,peripancreatic invasion,stageⅢ-Ⅳ,lymph node metastasis and distant metastasis were independent risk factors affecting the prognosis of pancreatic cancer in the elderly.[Conclusion]The prognosis of elderly patients with pancreatic cancer is affected by multiple factors,such as the degree of differentiation,age,maximum tumor diameter,peripancreatic invasion,clinical stage,lymph node metastasis and distant metastasis,and clinical attention should be paid to patients with such characteristics.