摘要
目的:探讨十二指肠乳头腺癌行胰十二指肠切除术患者生存时间的影响因素。方法:回顾性分析2013年3月—2015年3月行胰十二指肠切除术的十二指肠乳头腺癌患者61例,均于术后随访至2019年3月31日,统计患者生存时间。采用多因素logistic回归分析影响生存时间的独立危险因素。结果:行胰十二指肠切除术的十二指肠乳头腺癌患者61例随访末,均完成随访,平均生存时间(30.63±8.98)个月。单因素分析结果显示,不同性别、TNM分期、合并基础疾病、手术时间、术中出血量、术前血清CEA水平和术前血清CA19-9水平生存时间比较差异无统计学意义(P>0.05);年龄>60岁生存时间短于年龄≤60岁,肿瘤直径>2.5 cm生存时间短于肿瘤直径≤2.5 cm,低分化生存时间短于中高分化,血清胆红素>34.2μmol/L生存时间短于血清胆红素≤34.2μmol/L,局部淋巴结转移生存时间短于无局部淋巴结转移,差异均有统计学意义(P<0.05)。将上述差异有统计学意义的单因素纳入多因素logistic回归分析,结果显示,肿瘤直径>2.5 cm、低分化、总胆红素>34.2μmol/L和局部淋巴结转移为影响生存时间的独立危险因素。结论:十二指肠乳头腺癌行胰十二指肠切除术患者生存时间受多因素影响,其中肿瘤大小、分化程度、血清胆红素水平及局部淋巴结转移为其独立危险因素。
Objective:To explore the influencing factors of survival time in patients with duodenal papillary adenocarcinoma undergoing pancreatoduodenectomy.Methods:A retrospective analysis of 61 patients with duodenal papillary carcinoma who underwent pancreaticoduodenectomy from March 2013 to March 2015.All patients were followed up until March 31,2019,and their survival was calculated time.Multivariate logistic regression was used to analyze independent risk factors affecting survival time.Results:Sixty-one patients with duodenal papillary carcinoma who underwent pancreaticoduodenectomy were followed up at the end of follow-up.The univariate analysis showed that there was no significant difference in survival time between different genders,TNM stages,combined underlying diseases,surgical time,intraoperative blood loss,preoperative serum CEA levels,and preoperative serum CA19-9 levels(P>0.05);Age>60 years shorter than age≤60 years,tumor diameter>2.5 cm survival time shorter than tumor diameter≤2.5 cm,poorly differentiated survival time shorter than moderately differentiated,serum bilirubin>34.2μmol/L short survival time for serum bilirubin≤34.2μmol/L,the survival time of local lymph node metastasis was shorter than that without local lymph node metastasis,and the differences were statistically significant(P<0.05).A statistically significant single factor was included in the multivariate logistic regression analysis.The results showed that tumor diameters>2.5 cm,poor differentiation,total bilirubin>34.2μmol/L,and local lymph node metastasis were independent risk factors that affected survival.Conclusion:The survival time of patients with duodenal papillary adenocarcinoma undergoing pancreatoduodenectomy is affected by many factors,among which tumor size,degree of differentiation,serum bilirubin level,and local lymph node metastasis are independent risk factors.
作者
周小兵
蒋美芳
ZHOU Xiao-bing;JIANG Mei-fang(Department of General Surgery,Jintan District People's Hospital,Changzhou 213200,China;Department of Hemodialysis,Jintan District People's Hospital,Changzhou 213200,China)
出处
《中国现代普通外科进展》
CAS
2020年第3期190-193,共4页
Chinese Journal of Current Advances in General Surgery
关键词
十二指肠乳头腺癌
胰十二指肠切除术
生存时间
影响因素
Duodenal papillary adenocarcinoma
Pancreatoduodenectomy
Survival time
Influencing factors
