摘要
目的探讨胰腺癌病理类型构成比及不同病理类型胰腺癌患者的预后。方法提取美国国立癌症研究所SEER数据库2004年至2014年共92011例病理明确诊断为胰腺癌患者的临床病理数据。寿命表法计算1、3、5年生存率；Kaplan-Meier法绘制患者的生存曲线；单因素Cox回归分析不同病理类型预后的风险比（HR）。基线资料分析采用×。检验及独立样本t检验。结果92011例胰腺癌患者的5年总体生存率为7．6％，中位生存时间为8．8个月。导管腺癌及其他上皮来源胰腺癌、神经内分泌肿瘤、未分化癌、问质性癌及未分类罕见癌的构成比分别为85．78％、6．40％、6．67％、0．97％、0．10％、0．08％。各类型胰腺癌在年龄、性别、种族、发病部位等基线资料差异有统计学意义（P〈0．05）。导管腺癌、其他上皮来源胰腺癌、神经内分泌肿瘤、未分化癌、间质性癌及未分类罕见癌患者的5年生存率分别为4．2％、13．4％、49．2％、5．0％、29．2％、24．5％，中位生存时问分别为5个月、7个月、58个月、2个月、26个月、7个月。神经内分泌肿瘤远处转移率最低（35．0％），未分化癌最易发生远处转移（65．2％），其他各类型胰腺癌在诊断时基本已有半数患者发生远处转移。导管腺癌以外的上皮来源胰腺癌患者，5年生存率由高到低依次为实性假乳头状癌（87．3％）、囊腺癌（36．8％）、胰腺导管内乳头状癌（36．5％）、腺泡细胞癌（20．0％）、混合其他亚型的胰腺癌（19．7％）。其他类型的上皮源性胰腺癌患者5年生存率均低于8％，如胶样癌、鳞状细胞癌、腺鳞癌、印戒细胞癌。在神经内分泌肿瘤中，胰岛素瘤5年生存率（77．1％）高于神经内分泌瘤（NET，62．0％）及神经内分泌癌（NEC，46．5％）。结论胰腺癌患者总体预后差。不同病理类型胰腺癌对患者预后有重要影响。
Objective To study the component ratios of pancreatic carcinoma, and prognosis of patients with the different pathological types. Methods The data of 92 011 pancreatic carcinoma patients who were diagnosed by the definite pathological method from 2004 to 2014 were extracted from the US SEER database. The life table was used to calculate the 1-, 3- and 5-year survival rates. The Kaplan-Meier was used to construct the survival curves of the patients. The Cox univariate analysis was applied to evaluate the HR of the different pathological types, and the X2 test and independent sample t-test were used to evaluate the base- line data. Results The overall 5-year survival of 92 011 pancreatic carcinoma patients was 7.6%. The median survival time was 8. 8 months and the component ratios of the pancreatic ductal adenocarcinoma （PDAC） , pancreatic epithelium cancer bedside the PDAC, neuroendocrine tumors, undifferentiated carci- noma, mesenchymal carcinoma and rare cancer unclassified were 85.78%, 6.40%, 6. 67%, 0. 97%, 0. 10% and 0. 08% , respectively. The differences were statistically significant between the baseline data such as age, gender, race and position （P 〈 0. 05 ）. The overall 5-year survivals of the PDAC, pancreatic epithelium cancer beside the PDAC, neuroendocrine tumors, undifferentiated carcinoma, mesenchymal car- cinoma and rare cancer unclassified were 4.2% , 13.4% , 49.2% , 5.0%, 29.2% and 24.5% , respectively, and the median survival times were 5 months, 7 months, 58 months, 2 months, 26 months and 7 months respectively. The distant metastasis rate of neuroendocrine carcinoma was the lowest （35.0%）. The undifferentiated carcinoma was the most prone to distant metastases （65.2%）. Basically, half of the other types of pancreatic cancer had metastasis at the time of diagnosis. In pancreatic epithelium cancer beside the PDAC, the high to low 5-year survival rates were solid pseudopapillary carcinoma （87.3%） , cystadenocarcinoma （36.8%）, intraductal papillary mucinous neoplasm （36.5%） , acinar cell carcinoma （20.0%）,and pancreatic adenocarcinoma mixed with other subtypes （ 19.7% ）. The incidence of the other types of pancreatic carcinoma was less than 8%, such as mucinous carcinoma, squamous cell carcinoma, adenosqua- mous carcinoma and signet ring cell carcinoma. In neuroendocrine tumor, the 5-year survival rate of insulinoma （77.1%） was higher than those of neuroendocrine tumor （malignant） （NET, 62.0% ） and neuroendocrine carcinoma （NEC, 46.5% ）. Conclusion The prognosis of pancreatic carcinoma was poor, and the pathological types had a significant impact on the prognosis of the patients.
作者
李皇保
周俊
吴晓俊
闵捷
赵凤庆
刘文
黎亮
于费杰
陈帅
Li Huang-bao;Zhou Jun;Wu Xiaojun;Min Jie;Zhao Fengqing;Liu Wen;Li Liang;Yu Feijie;Chen Shuai.(Department of Hepatobiliary Surgery, the First Hospital of Jiaxing, Zhejiang 314000, China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2018年第4期258-262,共5页
Chinese Journal of Hepatobiliary Surgery
关键词
胰腺癌
预后
病理类型
SEER
Pancreatic carcinoma
Prognosis
Pathological types
Surveillance, epidemiology, and end results （SEER）
