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);

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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

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