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曾莲丽, 李双双, 岳鹏飞, 等. 一般临床特征与血液学参数在胰腺导管腺癌根治性切除术患者中的预后价值研究[J]. koko体育app 学报（医学版）, 2024, 55(3): 708-716. DOI:
引用本文: 曾莲丽, 李双双, 岳鹏飞, 等. 一般临床特征与血液学参数在胰腺导管腺癌根治性切除术患者中的预后价值研究[J]. koko体育app 学报（医学版）, 2024, 55(3): 708-716. DOI:
ZENG Lianli, LI Shuangshuang, YUE Pengfei, et al. The Value of Clinical Characteristics and Hematological Parameters for Prognostic Assessment of Pancreatic Cancer Patients Undergoing Radical Resection[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(3): 708-716. DOI:
Citation: ZENG Lianli, LI Shuangshuang, YUE Pengfei, et al. The Value of Clinical Characterist♊ics and Hematological Parameters for Prognostic Assessment of Pancreatic Cancer Patients Undergoing Radical Resection[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(3): 708-716. DOI:

一般临床特征与血液学参数在胰腺导管腺癌根治性切除术患者中的预后价值研究

The Value of Clinical Characteristics and Hematological Parameters for Prognostic Assessment of Pancreatic Cancer Patients Undergoing Radical Resection

  • 摘要:
    目的 分析胰腺导管腺癌（pancreatic ductal adenocarcinoma, PDAC）根治性切除术患者基线临床特征及血液学参数与预后的关系，为患者的临床风险分层提供依据。
    方法 收集koko体育app 华西医院2010年1月–2019年2月进行根治性手术的445例胰腺导管腺癌患者的临床资料，进行回顾性临床分析。采集患者一般临床特征、血液常规检查、 肿瘤学生物标志物等数据，探索了这些指标对PDAC患者术后总生存期的影响。使用Cox比例风险回归模型分析影响生存时间的相关因素。采用SPSS 23.0软件包进行数据统计分析。
    结果 手术后患者的中位总生存期（median overall survival, mOS）为17.0〔95%置信区间（confidence interval, CI）：15.0～19.0〕个月。在术后的第1年、第2年、第3年、第4年以及第5年，纳入患者的存活率分别为60.6%、33.4%、19.1%、12.7%和9.6%。多因素Cox风险比模型结果显示，影响PDAC患者术后存活率的独立危险因素包括：肿瘤部位〔风险比（hazards ratio, HR）=1.574，95%CI：1.233～2.011〕、肿瘤细胞分化水平（HR=0.687，95%CI：0.542～0.870）、是否存在神经受侵犯（HR=0.686，95%CI：0.538～0.876）、 TNM分期（HR=1.572，95%CI：1.252～1.974）、是否接受术后辅助治疗（HR=1.799，95%CI：1.390～2.328）、术前饮酒记录（HR=0.744，95%CI：0.588～0.943），以及术前血清中CA199水平（HR=0.742，95%CI：0.563～0.977）。
    结论 在PDAC患者中，肿瘤位于胰头、中高分化、无局部神经侵犯、TNM分期为Ⅰ期、术后接受辅助治疗、术前无饮酒史、术前CA199≤37 U/mL等特征与患者较好的预后显著相关。
     
    Abstract:
    Objective  To explore the relationship between baseline clinical characteristics and hematological parameters of patients undergoing radical resection for pancreatic ductal adenocarcinoma (PDAC) and their prognosis, and to provide references for stratifying the patients’ clinical risks.
    Methods  We retrospectively collected clinical data from 445 patients who underwent radical surgical treatment for PDAC at West China Hospital, Sichuan University between January 2010 and February 2019. Then, we conducted retrospective clinical analysis with the collected data. Data on patients’ basic clinical characteristics, routine blood test results, and tumor indicators were collected to explore their effects on the postoperative overall survival (OS) of PDAC patients. Cox proportional hazards regression was used to identify factors affecting OS. Statistical analysis was performed using the SPSS 23.0 software package.
    Results  The postoperative median overall survival (mOS) was 17.0 months (95% CI: 15.0-19.0). The 1, 2, 3, 4, and 5-year survival rates of the patients included in the study were 60.6%, 33.4%, 19.1%, 12.7%, and 9.6%, respectively. The multivariate Cox proportional hazards model analysis demonstrated that a number of factors independently affect postoperative survival in PDAC patients. These factors include tumor location (hazards ratio HR=1.574, 95% CI: 1.233-2.011), degree of tumor cell differentiation (HR=0.687, 95% CI: 0.542-0.870), presence of neural invasion (HR=0.686, 95% CI: 0.538-0.876), TNM staging (HR=1.572, 95% CI: 1.252-1.974), postoperative adjuvant therapy (HR=1.799, 95% CI: 1.390-2.328), preoperative drinking history (HR=0.744, 95% CI: 0.588-0.943), and high serum CA199 levels prior to the surgery (HR=0.742, 95% CI: 0.563-0.977).
    Conclusion  In PDAC patients, having tumors located in the head of the pancreas, moderate and high degrees of differentiated, being free from local neurovascular invasion, being in TNM stage Ⅰ, undergoing postoperative adjuvant therapy, no history of alcohol consumption prior to the surgery, and preoperative serum CA199 being less than or equal to 37 U/mL are significantly associated with a better prognosis.
     
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