276例胰腺癌临床预后因素分析

目的 探讨影响胰腺癌预后的因素.方法 回顾性分析1995年9月至2005年8月收治的276例胰腺癌患者的临床资料,采用Cox比例风险模型分析可能影响胰头癌、胰体尾癌预后的独立因素,用Kaplan-Meier方法描述不同位置胰腺癌的中位生存时间,并进行Log-rank和Breslow检验.结果 Cox比例风险模型发现包块直径、肠系膜上血管浸润情况和治疗方式是胰头癌预后的独立影响因素;年龄、淋巴结肿大和治疗方式是胰体尾癌预后的独立影响因素.根治术后胰头癌和胰体尾癌患者的中位生存时间分别为460 d和480 d,显著高于姑息治疗或放弃治疗患者的240 d和200 d.在肿瘤位置对生存时间的影响中,全胰癌患者总体中位生存时间为117 d,明显低于胰头癌的330 d和胰体尾癌的300 d.结论 根治性手术是目前改善胰腺癌预后最好的方法.包块直径＞4 cm、肠系膜上血管浸润的胰头癌预后较差;年龄≤60岁和淋巴结肿大的胰体尾癌预后较差.胰头癌与胰体尾癌的预后相近,全胰癌是胰腺癌中极为晚期的状态,预后极差.

Factors influencing the prognosis of 276 patients with pancreatic cancer

Objective To analyze the factors influencing the prognosis of patients with pancreatic cancer.Methods The clinical data of 276 patients with pancreatic cancer who had been admitted to our department from September 1995 to August 2005 were retrospectively analyzed.Cox regression analysis was used to screen out independent risk factors influencing the prognosis of patients with pancreatic head cancer or pancreatic body and tail cancer,and Kaplan-Meier method to calculate the median survival time.The effects of tumor location on the prognosis were examined by Log-rank and Breslow test.Results Cox regression analysis showed that the diameter of tumor,invasion of the superior mesenteric vessel and treatment method were the independent risk factors influencing the prognosis of patients with pancreatic head cancer;while age,lymphadenectasis and treatment method were the independent risk factors influencing the prognosis of patients with pancreatic body and tail cancer.The median survival time of patients with pancreatic head cancer and pancreatic body and tail cancer after radical resection were 460 days and 480 days,which were significantly longer than 240 days and 200 days of patients who received palliative treatment or gave up treatment.The median survival time of patients with whole pancreatic cancer was 117 days,which was significantly shorter than 330 days of patients with pancreatic head cancer and 300 days of pancreatic body and tail cancer.Conclusions Radieal resection is currently the best choice for pancreatic cancer.The prognosis is poor for patients with pancreatic head cancer(diameter≥4 cm)and invasion of the superior mesenteric vessel.Patients with age≤60 and lymphadenectasis are the factors resulting in poor prognosis of pancreatic body and tail cancer.The prognosis of patients with pancreatic head cancer and pancreatic body and tail cancer are close.Patients with whole pancreatic cancer is in the terminal stage with the worst prognosis.