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目的探讨胰腺癌手术患者的生存状况及其预后的相关因素。方法回顾性分析新疆医科大学第一附属医院2002年1月1日-2010年12月31日收治的152例胰腺癌手术患者的临床资料,对肿瘤大小、术前糖类抗原199(CA199)水平、糖类抗原242(CA242)水平、癌胚抗原(CEA)水平、手术方式、有无淋巴结转移、有无远处转移、临床分期及有无术后治疗等分别采用Kaplan-Meier及Cox比例风险模型进行单因素及多因素分析。结果完整随访的152例腺癌患者中存活39例(25.7%),死亡113例(74.3%),中位生存时间为277d,6个月、1年、2年及3年生存率分别为68.1%、38.3%、27.7%、23.6%;单因素分析显示肿瘤大小、术前CA199水平、手术方式、有无淋巴结转移、有无远处转移、临床分期及有无术后治疗是影响胰腺癌手术患者预后因素,差异均有统计学意义(P<0.05);多因素分析显示肿瘤大小、有无淋巴结转移、有无远处转移及手术方式为影响胰腺癌手术患者的独立预后因素(P<0.05)。结论胰腺癌手术患者的肿瘤大小、有无淋巴结转移、有无远处转移及手术方式是预后的主要影响因素。
Objective To investigate the survival status and prognosis of pancreatic cancer patients. Methods The clinical data of 152 patients with pancreatic cancer admitted to the First Affiliated Hospital of Xinjiang Medical University from January 1, 2002 to December 31, 2010 were retrospectively analyzed. The tumor size, the level of preoperative carbohydrate antigen 199 (CA199) , Carbohydrate antigen 242 (CA242) level, carcinoembryonic antigen (CEA) level, operation mode, with or without lymph node metastasis, with or without distant metastasis, clinical stage and whether postoperative treatment were used Kaplan-Meier and Cox proportional hazards Model for single factor and multivariate analysis. Results A total of 152 patients with adenocarcinoma survived in 39 cases (25.7%) and 113 died (74.3%) with a median survival time of 277 days. The 6-month, 1-year, 2-year and 3-year survival rates were 68.1 %, 38.3%, 27.7% and 23.6% respectively. Univariate analysis showed that tumor size, preoperative CA199 level, operation mode, lymph node metastasis, distant metastasis, clinical staging and postoperative treatment were the risk factors influencing pancreatic cancer surgery The prognosis of patients with pancreatic cancer were significantly different (P <0.05). Multivariate analysis showed that the size of the tumor, lymph node metastasis, distant metastasis and surgical outcome were independent predictors of pancreatic cancer surgery (P <0.05) ). Conclusions The size of the tumor, the presence or absence of lymph node metastasis, the distant metastasis and the surgical method in patients with pancreatic cancer are the main prognostic factors.