原发性十二指肠乳头癌的预后因素分析

目的 探讨影响原发性十二指肠乳头癌预后的因素.方法 回顾性分析1995年6月至2005年6月厦门大学附属东南医院收治的73例原发性十二指肠乳头癌患者的临床资料.对患者性别、年龄、有无黄疸、肿瘤直径、病程时间、TBil、肿瘤分化程度、有无淋巴结转移、手术方式以及根治程度等10个因素采用Log-rank检验进行单因素分析,再采用Cox多因素回归模型进行多因素分析.生存时间用中位数表示,Kaplan-Meier法绘制生存曲线.结果 本组患者中位生存时间为34个月.患者年龄、有无黄疸、肿瘤直径、病程时间、TBil、肿瘤分化程度、有无淋巴结转移、手术方式及根治程度与预后密切相关(x2=18.315,4.562,7.989,10.660,11.138,7.995,5.423,114.464,83.383,P＜0.05);而患者性别与预后无关(x2 =1.720,P＞0.05).肿瘤分化程度、手术方式及根治程度是影响患者预后生存的独立因素(RR=2.039,2.178,5.798,P＜0.05).结论 肿瘤分化程度、手术方式及根治程度是影响十二指肠乳头癌预后生存的独立因素,标准手术方式的选择及根治程度对患者预后具有重要影响.

Prognostic factors of primary duodenal papilla carcinoma

Objective To study the prognostic factors of primary duodenal papilla carcinoma.Methods The clinical data of 73 patients with primary duodenal papilla carcinoma who were admitted to the Dongnan Hospital of Xiamen University from June 1995 to June 2005 were retrospectively analyzed.Ten factors including gender,age,jaundice,tumor size,course of disease,total bilirubin,tumor differentiation,lymphatic metastasis,type of surgery and degree of resection were analyzed by Log-rank test.Prognostic factors with significant difference were further analyzed by the Cox regression model.The survival curve was drawn by using the Kaplan-Meier method.Results The median survival time of the patients was 34 months.Age,jaundice,tumor size,course of disease,total bilirubin,tumor differentiation,lymphatic metastasis,type of surgery and degree of resection were correlated with the prognosis (x2 =18.315,4.562,7.989,10.660,11.138,7.995,5.423,114.464,83.383,P＜0.05),while no significant difference was found between gender and prognosis ( x2 =1.720,P ＞ 0.05 ).Multivariate analysis demonstrated that tumor differentiation,type of surgery and degree of resection were the factors influencing the prognosis of patients with duodenal papilla carcinoma (RR =2.039,2.178,5.798,P＜0.05).Conclusions Tumor differentiation,type of surgery and degree of resection are the dependent factors influencing the prognosis of patients with duodenal papilla carcinoma.The standard type of surgery and degree of resection are important for the prognosis of patients.