274例胰腺癌临床病理特征及影响患者预后的危险因素

沈红; 汪秀云; 许辉琼; 刘霞

274例胰腺癌临床病理特征及影响患者预后的危险因素

四川大学华西医院腹部肿瘤科

基金项目:

基金：四川省科技厅科技支撑计划基金资助项目 (16PJ30170);

计量
- 文章访问数: 4369
- HTML全文浏览量: 1588
- PDF下载量: 154
- 被引次数: 0
出版历程
- 收稿日期: 2018-10-20

Analysis of Clinicopathological Features of 274 Cases of Pancreatic Cancer and Risk Factors Affecting Prognosis

Funds:

基金：四川省科技厅科技支撑计划基金资助项目 (16PJ30170);

摘要

摘要: 目的分析胰腺癌临床病理特征及影响患者预后的危险因素。方法回顾性分析2012年3月至2017年3月四川大学华西医院274例胰腺癌患者临床资料及随访情况 (随访截止至2018年6月或患者死亡) 。采用Kaplan-Meier法评估患者生存状况, 以Log-rank检验进行单因素分析, 以Cox比例风险回归模型进行多因素分析, 筛选出影响胰腺癌患者预后的危险因素。结果至随访终点, 274例患者中, 242例死亡, 32例存活, 中位生存时间为5.7个月, 1 a、2 a、3 a生存率分别为24.6%、10.7%、4.6%。单因素分析显示, 肿瘤部位、肿瘤大小、c TNM分期、有无肝转移、有无淋巴结转移、治疗方式、血清CEA水平、血清CA199水平、血清CA242水平、NLR与胰腺癌患者预后有关 (P <0.05) , 而性别、年龄、体质量指数、有无糖尿病史、有无吸烟史、血清ALB水平与胰腺癌患者预后无关 (P> 0.05) 。Cox多因素分析显示, 肿瘤大小>2 cm、c TNM分期为III～IV期、淋巴结转移、血清CA199>37 U/m L、血清CA242>20 U/m L、NLR> 4均是胰腺癌患者预后的独立危险因素 (P <0.05) , 而手术治疗是胰腺癌患者预后的有益因素 (P <0.05) 。结论肿瘤大小、c TNM分期、淋巴结转移、血清CA199及CA242水平、NLR及治疗方式与胰腺癌患者预后密切相关。
- 胰腺癌 /
- 临床病理特征 /
- 预后 /
- 危险因素
Abstract: Objective To analyze the clinicopathological features of pancreatic cancer and the risk factors affecting the prognosis. Methods The clinical data and follow-up condition of 274 patients with pancreatic cancer in our hospital from March 2012 to March 2017 were retrospectively analyzed (the follow-up was until June 2018 or the patient died) . Kaplan-Meier method was used to evaluate the survival of patients. Log-rank test was used for univariate analysis. Cox proportional hazard regression model was used for multivariate analysis to screen out the risk factors affecting the prognosis of patients with pancreatic cancer. Results By the end of follow-up, 242 cases died and 32 cases survived among 274 cases of patients, and the median survival time was 5.7 months, and the1-year, 2-year and 3-year survival rates were 24.6%, 10.7% and 4.6% respectively. Univariate analysis showed that tumor location, tumor size, c TNM stage, presence or absence of liver metastasis or lymph node metastasis, treatment methods, serum CEA level, serum CA199 level, serum CA242 level and NLR were associated with prognosis in patients with pancreatic cancer (P < 0.05) , but gender, age, BMI, presence or absence of diabetes history or smoking history, serum ALB level were not associated with prognosis in patients with pancreatic cancer (P > 0.05) . Cox multivariate analysis showed that tumor size > 2 cm, c TNM stage III-IV, lymph node metastasis, serum CA199 > 37 U/m L, serum CA242 > 20 U/m Ll and NLR > 4 were independent risk factors for prognosis of patients with pancreatic cancer (P<0.05) , and surgical treatment was a beneficial factor for prognosis of patients with pancreatic cancer (P < 0.05) . Conclusions Tumor size, c TNM stage, lymph node metastasis, serum CA199 and CA242 levels, NLR and treatment methods are closely related to the prognosis of patients with pancreatic cancer.
- Pancreatic cancer /
- Clinicopathological features /
- Prognosis /
- Risk factors

HTML全文

参考文献(20)

[1]杨尹默.胰腺癌外科治疗的现状、存在问题与展望[J].中国普通外科杂志, 2016, 25 (9) :1231-1235.
[2]吴永杰, 刘海亮, 胡明根, 等.术前中性粒细胞与淋巴细胞比值对胰腺癌预后的判断价值[J].中华医学杂志, 2015, 95 (28) :2291-2293.
[3]雷学芬, 林劼, 江利锋, 等.立体定向放射治疗中晚期胰腺癌临床疗效观察[J].昆明医科大学学报, 2015, 36 (8) :103-106.
[4]刘肇修, 肖明兵, 江枫, 等.胰腺癌患者预后的影响因素分析及其对生存结局的预测价值[J].山东医药, 2016, 56 (40) :53-55.
[5]秦仁义.指导手术方式选择的胰腺癌分型及其与TNM分期相关性的探讨[J].中华外科杂志, 2015, 53 (7) :488-491.
[6]	[6]KURIHARA T, KOGO M, ISHII M, et al.Practical prognostic index for survival in patients with unresectable pancreatic cancer treated with gemcitabine or S-1[J].Hepato-gastroenterology, 2015, 62 (138) :478-484.
[7]	[7]IPPEI M, YOSHIAKI M, MAKOTO S, et al.Proposed preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after surgical resection:A multi-center retrospective study[J].Pancreatology, 2015, 15 (6) :674-680.
[8]	[8]AHMAD J, GRIMES N, FARID S, et al.Inflammatory response related scoring systems in assessing the prognosis of patients with pancreatic ductal adenocarcinoma:a systematic review[J].Hepatobiliary&Pancreatic Diseases International, 2014, 13 (5) :474-481.
[9]	[9]YAMAMOTO T, YAGI S, KINOSHITA H, et al.Long-term survival after resection of pancreatic cancer:A single-center retrospective analysis[J].World Journal of Gastroenterology, 2015, 21 (1) :262-268.
[10]李翀, 唐纯娜, Chong LI, 等.转录因子Sp3表达与胰腺癌临床病理特征及预后的关系[J].中国现代医学杂志, 2015, 25 (18) :12-15.
[11]王卓, 刘德军, 霍砚淼, 等.淋巴结转移对胰腺癌患者生存期的影响[J].中华肝胆外科杂志, 2016, 22 (10) :672-676.
[12]马学柱.血清CA199CA125CA242癌胚抗原表达水平与胰腺癌的早期诊断和预后转归的关联性研究[J].山西医药杂志, 2016, 45 (13) :1543-1545.
[13]杨柳, 闫欢, 石燕, 等.晚期胰腺癌患者血清CA125, CA199水平与肝转移的关系[J].中国实验诊断学, 2017, 21 (5) :770-773.
[14]彭维忠, 杨浩洁, 张克兰, 等.外周血NLR或PLR与结直肠癌预后的相关性研究进展[J].中国免疫学杂志, 2017, 33 (12) :1902-1906.
[15]张文琪, 郝权.术前外周血NLR对上皮性卵巢癌患者预后的影响[J].中国肿瘤临床, 2014, 41 (10) :634-638.
[16]	[16]KANG M H, GO S I, SONG H N, et al.The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer[J].British Journal of Cancer, 2014, 111 (3) :452-460.
[17]	[17]BHATTI I, PEACOCK O, LLOYD G, et al.Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma:neutrophil-lymphocyte versus platelet-lymphocyte ratio[J].American Journal of Surgery, 2010, 200 (2) :197-203.
[18]	[18]XUE P, KANAI M, MORI Y, et al.Neutrophil-to-lymphocyte ratio for predicting palliative chemotherapy outcomes in advanced pancreatic cancer patients[J].Cancer Medicine, 2014, 3 (2) :406-415.
[19]杨科, 单祖建, 周琼华, 等.可溶性细胞因子受体及基质金属蛋白酶与胰腺癌的关系[J].昆明医科大学学报, 2017, 38 (1) :99-102.
[20]孙岩娜, 张华, 张瑞丽, 等.新疆维吾尔族与汉族入院治疗胰腺癌患者353例预后因素分析[J].中华肿瘤防治杂志, 2013, 20 (18) :1436-1440.

相关文章(20)

[1]	张志英, 时培景. 血清CD46、KLF7、FURIN与慢性宫颈炎合并HPV感染患者临床病理特征的关系及预后预测价值, 昆明医科大学学报.
[2]	龚春梅, 熊蓓蓓, 李立兰, 吴明铭, 罗露. 乳腺癌组织中LDH-C4与CMKLR1的表达及其与临床病理特征、肿瘤标志物和预后的关系, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20260609
[3]	秦瑞峰, 薛佳栋, 张佳, 刘帆, 张绍辉, 尹立阳, 袁增江. SKI通过ROS/JNK通路诱导铁死亡干预胰腺癌恶性行为, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20251005
[4]	楼海均, 张振宇, 苏热彦·阿力木江, 孟·孟根, 陈航, 乌都木丽. TMEM33在肺腺癌的表达特征及临床病理特征, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20250304
[5]	沈仕俊, 尹亚梅, 宋莉, 向春明, 李恒. 营养干预对局部晚期胰腺癌患者生活质量和生存预后的影响, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20250418
[6]	党娇, 王娜, 韩林育. 卵巢癌患者血清LCN2、LTBP2表达及其与临床病理特征和预后的关系, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20250714
[7]	肖玉华, 闫玲新, 曹吉东, 柴金华. 胰腺癌组织中LMO2、CAPRIN1表达及其与预后的相关性, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20251216
[8]	冯润林, 邓宗柒, 吴梦瑶, 王云娜, 王瑜, 刘桂兰, 陶燕萍. GJB4基因在胰腺癌中的表达及其与患者临床病理特征的关系, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20250110
[9]	刘思佳, 杨亚英, 彭超, 李亚敏. 增强CT及MRI检查在胰腺癌术前TNM分期中的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230628
[10]	高婷, 黄胜, 郭瑢, 陈德滇. 乳腺粘液腺癌的临床病理特征及预后分析, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230306
[11]	李伟杰, 陈丽琴, 李亚玲, 韩永慧, 李小娟, 颜粉冬. 百日咳流行病学、临床特征和重症百日咳148例危险因素分析, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220824
[12]	吴华杰, 张楠, 李磊, 乔涵, 李国萍. 甲状腺癌发病的危险因素及预防策略研究进展, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220526
[13]	路伟民, 杨小涛, 朱瑛, 黄艺, 陈后余, 金海凤, 王艳春. 儿童恙虫病175例的临床特征及重症恙虫病危险因素, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220814
[14]	耿证琴, 谢琳, 宋红莉, 李蓉, 廖冶丹, 张雪琪, 唐嘉黛. 十二指肠腺癌88例临床特征及相关预后因素, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220109
[15]	胡昌猛, 吴琳. Silva分型与宫颈HPV相关腺癌预后的相关性, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220817
[16]	李京辉, 朱明, 曲海, 李秋宇, 吴玉娟, 杨贺英, 王郁竹, 李妍平. miR-490-3p调控SW1990胰腺癌细胞上皮间充质转化, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210305
[17]	王静, 唐莲芳, 顾美群, 许小艳, 余建华, 何山, 李紫薇, 毕凯, 刘丽巧, 赵琼, 米弘瑛. 新生儿坏死性小肠结肠炎的危险因素及早期临床特点, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20211118
[18]	雷学芬. 立体定向放射治疗中晚期胰腺癌临床疗效观察, 昆明医科大学学报.
[19]	石磊. 31例脑胶质瘤临床预后及其影响因素分析, 昆明医科大学学报.
[20]	谭向来. 以RIFLE标准评估住院患者急性肾损伤发病率、预后及相关危险因素, 昆明医科大学学报.