Ulla-Rocha Jose Luis, Alvarez-Prechous Angel, Paz-Esquete Javier, Alvarez Carlos Alvarez, Lopez-Clemente Pedro, Dominguez-Comesaña Elias, Vazquez-Astray Enrique
Digestive Disease Service, Pontevedra Hospital Complex, Pontevedra, Spain.
J Gastrointest Cancer. 2010 Sep;41(3):165-72. doi: 10.1007/s12029-010-9136-1.
Pancreatic ductal adenocarcinoma is a type of neoplasm with a high mortality rate. There are a number of different procedures that may be followed in the study of the pancreas; one such procedure is endoscopic ultrasonography (EUS).
This study aimed to retrospectively evaluate the impact on patient survival of a biliopancreatic EUS performed 2 months prior to the first treatment session of the pancreatic ductal adenocarcinoma.
We carried out a retrospective evaluation of the medical case histories of our patients who had been diagnosed with pancreatic ductal adenocarcinoma over a period of 10 years (1 Jan 1999-31 Dec 2008), combining the computer archives of our Pathological Anatomy (biopsy and cytology) Dept. and those of the Digestive Department's Endoscopic Ultrasonography Unit in order to exclude any pancreatic neoplasms derived from other origins. Information regarding the patients' age, sex, tumor location, and various diagnostic tests (EUS, EUS-fine-needle aspiration (FNA), helical computed tomography (CT), multidetector-row CT (MDCT)) were recorded, along with the different treatments that had been followed in each case.
When the survival rates of patients diagnosed with and without EUS were compared, evaluating the average survival rate and the survival rate after 1, 3, and 5 years, respectively, the differences in the results proved to be statistically significant (p = 0.014) in favor of the diagnosis with EUS. However, no significant differences were found when using other diagnostic imaging methods, such as EUS-FNA (p = 0.271), helical CT (p = 0.843), or MDCT (p = 0.738). To evaluate other influencing survival factors, a study was undertaken to record data depending on the sex of the patients. Results showed a higher survival rate in the female patients with a median of 6.57 months compared to that of the male patients with a median of 4.7 months (p = 0.014). Variables, which had resulted significant prior to treatment, were included in a multivariate Cox regression model, after which only the sex and EUS remained significant.
A biliopancreatic EUS carried out during the 2 months prior to the start of the treatment of the pancreatic ductal adenocarcinoma has a statistically significant impact on the patient survival rate. We believe that this is due to the possibility of a very-early-stage diagnosis of the adenocarcinoma permitted by the use of this technique.
胰腺导管腺癌是一种死亡率很高的肿瘤。在胰腺研究中有多种不同的检查方法；其中一种是内镜超声检查（EUS）。
本研究旨在回顾性评估在胰腺导管腺癌首次治疗前2个月进行的胆胰管EUS对患者生存率的影响。
我们对10年期间（1999年1月1日至2008年12月31日）被诊断为胰腺导管腺癌的患者的病历进行了回顾性评估，结合了病理解剖学（活检和细胞学）科和消化内科内镜超声检查室的计算机存档，以排除任何源自其他部位的胰腺肿瘤。记录了患者的年龄、性别、肿瘤位置以及各种诊断检查（EUS、EUS细针穿刺活检（FNA）、螺旋计算机断层扫描（CT）、多排探测器CT（MDCT））的信息，以及每个病例所采用的不同治疗方法。
比较有和没有进行EUS诊断的患者的生存率，分别评估平均生存率以及1年、3年和5年后的生存率，结果差异具有统计学意义（p = 0.014），支持EUS诊断。然而，使用其他诊断成像方法，如EUS-FNA（p = 0.271）、螺旋CT（p = 0.843）或MDCT（p = 0.738）时，未发现显著差异。为了评估其他影响生存的因素，进行了一项根据患者性别记录数据的研究。结果显示，女性患者的生存率较高，中位生存期为6.57个月，而男性患者的中位生存期为4.7个月（p = 0.014）。将治疗前有显著意义的变量纳入多因素Cox回归模型，之后只有性别和EUS仍然具有显著意义。
在胰腺导管腺癌治疗开始前2个月进行的胆胰管EUS对患者生存率有统计学意义的影响。我们认为这是由于使用该技术有可能对腺癌进行极早期诊断。
