专题研究(Monographic Study)

壶腹腺癌胰十二指肠切除术后预后相关因素分析

Published at: 2016年第25卷第9期

黄秀芸 1 , 王向阳 1 , 杨瑜明 1 , 吴明浩 1 , 刘展 1
1 湖南师范大学第一附属医院/湖南省人民医院 消化内科,湖南 长沙 410006
通讯作者 展 刘 Email: liuzhan2004@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.09.004
基金:

摘要

目的:探讨影响壶腹腺癌患者行胰十二指肠切除术预后相关因素。方法:回顾2007年1月—2014年12月期间接受胰十二指肠切除术治疗的壶腹腺癌患者的临床及病理资料,分析患者术后生存的影响因素。结果:全组患者术后1、3、5年生存率分别为87.5%、64.3%、54.5%。单因素分析显示,术前总胆红素、直接胆红素、CEA、CA19-9、CA242、肿瘤分化程度、肿瘤浸润深度、淋巴结转移、肿瘤分期、胰腺侵犯、神经侵犯、术后辅助治疗是影响壶腹腺癌患者术后生存的影响因素(均P<0.05)。多因素分析显示,CEA、肿瘤浸润深度是影响壶腹腺癌患者术后生存的独立影响因素(均P<0.05)。结论:壶腹腺癌患者行胰十二指肠切除术后的预后与多种因素相关,CEA、肿瘤浸润深度是评价壶腹腺癌患者预后最重要的指标。


Prognostic factors for adenocarcinoma of the ampulla of Vater after pancreaticoduodenectomy

Abstract

Objective: To investigate the prognostic factors in patients with adenocarcinoma of the ampulla of Vater after pancreaticoduodenectomy. Methods: The clinical and pathological data of patients with adenocarcinoma of the ampulla of Vater undergoing pancreaticoduodenectomy from January 2007 to December 2014 were reviewed. The influential factors for postoperative survival of the patients were analyzed. Results: In the entire group of patients, the postoperative 1-, 3- and 5-year survival rate was 87.5%, 64.3% and 54.5% respectively. Univariate analysis showed that preoperative level of total bilirubin, direct bilirubin, CEA, CA19-9 and CA242 and degree of tumor differentiation, depth of infiltration, lymphatic metastasis, tumor stage, involvement of pancreas, neural invasion and postoperative adjuvant therapy were influential factors for survival. Multivariate analysis indicated that preoperative CEA level and depth of infiltration were independent prognostic factors (both P<0.05). Conclusion: Multiple factors are related to the prognosis of patients with adenocarcinoma of the ampulla of Vater after pancreaticoduodenectomy, and among them, the CEA level and the depth of infiltration are the most important indicators for estimating the prognosis of the patients.


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引用

引用本文: 秀芸 黄, 向阳 王, 瑜明 杨, 明浩 吴, 展 刘. 壶腹腺癌胰十二指肠切除术后预后相关因素分析[J]. 中国普通外科杂志, 2016, 25(9): 1247-1252.
Cite this article as: HUANG Xiuyun, WANG Xiangyang, YANG Yuming, WU Minghao, LIU Zhan . Prognostic factors for adenocarcinoma of the ampulla of Vater after pancreaticoduodenectomy [J]. Chin J Gen Surg, 2016, 25(9): 1247-1252.