胰腺癌和慢性胰腺炎的相关因素

目的:对比胰腺癌(pancreatic carcinoma,PC)和慢性胰腺炎(chronic pancreatitis,CP)的相关因素,为临床早期发现PC提供一定帮助.方法:对比分析新疆医科大学第一附属医院2005-01/2010-06住院胰腺癌(pancreaticcarcinoma,PC)患者265例及同期住院期间慢性胰腺炎(chronic pancreatitis,CP)患者294例,并进行单因素分析及多因素的非条件Logistic回归分析胰腺癌相关因素.结果:单因素分析显示:年龄、民族、吸烟、吸烟>20支/d、饮酒、饮酒>40g/d且>10年、糖尿病、胆石症、血、尿淀粉酶、空腹血糖水平、门冬氨酸氨基转移酶、丙氨酸氨基转移酶、CA19-9水平在2组间差异有统计学意义(P<0.05).多因素非条件Logistic回归分析显示:年龄(OR=1.607,P<0.05),CA19-9>35KU/L(OR=1.004,P<0.05),空腹血糖>6.4mmol/L(OR=1.453,P<0.05)是胰腺癌发生的独立危险因素.对265例胰腺癌患者用Logistic回归方程预测发现251例胰腺癌,正确率为94.7%;对294例慢性胰腺炎患者中用Logistic回归方程预测有282例非胰腺癌,正确率为95.9%;总正确率为95.3%.结论:对具备年龄、CA19-9、空腹血糖水平等高危因素的CP患者应定期监测空腹血糖及CA19-9,以期早期发现PC,对临床工作具有指导意义.

Investigation of risk factors for pancreatic carcinoma and chronic pancreatitis

AIM: To compare risk factors for pancreatic cancer and chronic pancreatitis to find clues to the early diagnosis of pancreatic cancer. METHODS: The clinical data for 265 patients with pancreatic carcinoma and 294 patients with chronic pancreatitis who were treated at our hospital from January 2005 to October 2010 were analyzed comparatively. Univariate and multivariate analyses were performed to examine factors affecting the incidence of pancreatic carcinoma using logistic regression models. RESULTS: Univariate analysis showed that age, nation, smoking, smoking >20 cigarettes/day, drinking, alcohol >40 g/d, alcohol >10 years, diabetes, cholelithiasis, blood and urine amylase, fasting blood sugar level, AST level, ALT level, CA19-9 level differed significantly between the two groups. Multivariate analysis showed that age (OR = 1.607, P < 0.05), CA19-9 >35 KU/L (OR = 1.004, P<0.05), and fasting blood sugar level >6.4 mmol/L (OR = 1.453, P<0.05) were independent risk factors for pancreatic carcinoma. Using regression analysis, 251 (94.7%) of 265 cases of pancreatic carcinoma and 282 (95.9%) of 294 cases of chronic pancreatitis were predicted. The total accuracy is 95.3%. CONCLUSION: Chronic pancreatitis patients with significant risk factors for pancreatic cancer should be regularly monitored for early detection of pancreatic cancer.