摘要
目的:探讨十二指肠乳头癌行根治性切除术后5年生存率的影响因素。方法:回顾性分析山东大学齐鲁医院2001年1月—2010年1月收治的68例十二指肠乳头癌行胰十二指肠切除术患者的临床资料,随访截至2015年1月。Kaplan-Meier法计算生存率,并描绘生存曲线,Log-Rank检验比较生存差异。Cox比例风险模型逐步回归法筛选影响十二指肠乳头癌行PD术患者预后的独立因素。结果:随访时间4~168个月,中位随访时间(57.00±19.93)个月。5年累积生存率为48.5%。单因素分析显示,术前血清总胆红素水平、十二指肠壁浸润程度、淋巴结转移和肿瘤TNM分期参与影响了十二指肠乳头癌行根治术的5年生存率。Cox比例风险模型多因素分析结果显示,十二指肠壁浸润程度和肿瘤TNM分期是影响十二指肠乳头癌行PD术5年生存率的独立影响因素。结论:十二指肠乳头癌行PD根治术后5年生存率与术前血清总胆红素水平、十二指肠壁浸润程度、淋巴结转移和肿瘤TNM分期等多种因素有关;十二指肠壁浸润程度和肿瘤TNM分期是影响十二指肠乳头癌行PD术5年生存率的独立影响因素。
Objective： To evaluate the prognostic factors for duodenalpapilla carcinoma （DPC） treated by pancreatoduodenectomy （PD）. Methodst Clinicopathological data of 68 patients with duodenalpapilla carcinoma who undergone PD and finally diagnosed by surgery and histopathology from January 2001 to June 2010 were retrospectively analyzed. The patients were followed-up until 2015. Survival analysis was conducted using the Kaplan-Meier survival and Cox proportional hazards model analysis. The difference in survival curves was evaluated with a log-rank test. Results： The patients were followed-up with a median follow-up of 57 months （ranging from 4 months to 168 months）. The univariate analysis showed that increased serum levels of total bilirubin were correlated with a poor prognosis, as well as a senior grade of infiltration depth, lymph node metastases, and TNM stage （P=0.043, 0.003, 0.004 0.002, respectively）. Only increased serum levels of total bilirubin and a senior grade of TNM stage retained their significance when adjustments were made for other known prognostic factors in Cox multivariate analysis （RR=2.031, P=0.031 and RR=2.255, P=0.029）. Conclusions： Increased serum levels of total bilirubin were correlated with a poor prognosis, as well as a senior grade of infiltration depth, lymph node metastases, and TNM stage. Only increased serum levels of total bilirubin and a senior grade of TNM stage can serve as independent prognosis indexes in the evaluation of patients with DPC after PD.
出处
《中国现代普通外科进展》
CAS
2017年第8期630-634,共5页
Chinese Journal of Current Advances in General Surgery
