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胰腺癌患者的预后因素。

Prognostic factors in patients with pancreatic cancer.

作者信息

Zhang DE-Xiang, Dai Yue-DI, Yuan Su-Xu, Tao Li

机构信息

Department of General Surgery, Jinshan Hospital Affiliated to Fudan University, Shanghai 200540;

出版信息

Exp Ther Med. 2012 Mar;3(3):423-432. doi: 10.3892/etm.2011.412. Epub 2011 Dec 8.

Abstract

The identification of prognostic factors for pancreatic cancer patients could provide insightful information for their management in the clinic. A total of 302 pancreatic cancer patients were enrolled in this study. The clinicopathological characteristics, treatment selection and laboratory test data were retrospectively retrieved from the medical records and follow-up data were obtained via telephone interview. Cox survival analysis was used to assess the potential prognostic factors, and survival curves were obtained by Kaplan-Meier analyses. The mortality rate of the patients was 83.4% (252/302) and the median survival of these patients was 6.1 months, with 1-, 2- and 3-year survival rates of 30.1 (91/302), 10.6 (32/302) and 2.6% (8/302), respectively. The most influential factors for the survival of these patients were the site of primary cancer, tumor stage, treatment selection, serum levels of glutamic-pyruvic transaminase, albumin, lactate dehydrogenase and hemoglobin, and white blood cell counts (P<0.05). The median survival of patients who did not receive any treatment or just received supportive treatment was 1.3 months, while the median overall survival of patients who underwent surgery, chemotherapy, biliary drainage therapy, arterial interventional chemotherapy and comprehensive treatment was 11.0, 7.3, 3.5, 9.0 and 11.0 months, respectively (P<0.05). Furthermore, single-drug chemotherapy was not statistically associated with patient survival in those who received the multi-drug regimen (P>0.05). However, the mortality risk of patients who received platinum chemotherapy was decreased [hazard ratio (HR)=0.56, 95% CI 0.35-0.88, P=0.011] compared to the patients who did not receive this treatment (P<0.05). Tumor stage, treatment selection, serum albumin levels, urea nitrogen, CA19-9, white blood cell and platelet counts were independent prognostic factors for the prediction of survival in pancreatic cancer. Future studies are required in order to verify these data. Chemotherapy with platinum regimens could improve overall survival in patients with pancreatic cancer.

摘要

确定胰腺癌患者的预后因素可为临床治疗提供有价值的信息。本研究共纳入302例胰腺癌患者。回顾性收集病历中的临床病理特征、治疗选择及实验室检查数据,并通过电话随访获取随访数据。采用Cox生存分析评估潜在的预后因素,通过Kaplan-Meier分析绘制生存曲线。患者死亡率为83.4%(252/302),中位生存期为6.1个月,1年、2年和3年生存率分别为30.1%(91/302)、10.6%(32/302)和2.6%(8/302)。对这些患者生存影响最大的因素包括原发癌部位、肿瘤分期、治疗选择、血清谷丙转氨酶、白蛋白、乳酸脱氢酶和血红蛋白水平以及白细胞计数(P<0.05)。未接受任何治疗或仅接受支持治疗的患者中位生存期为1.3个月,而行手术、化疗、胆道引流治疗、动脉介入化疗及综合治疗的患者中位总生存期分别为11.0、7.3、3.5、9.0和11.0个月(P<0.05)。此外,在接受多药方案治疗的患者中,单药化疗与患者生存无统计学关联(P>0.05)。然而,与未接受铂类化疗的患者相比,接受铂类化疗的患者死亡风险降低[风险比(HR)=0.56,95%可信区间0.35-0.88,P=0.011](P<0.05)。肿瘤分期、治疗选择、血清白蛋白水平、尿素氮、CA19-9、白细胞及血小板计数是预测胰腺癌患者生存的独立预后因素。需要进一步研究以验证这些数据。铂类方案化疗可改善胰腺癌患者的总生存期。

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Prognostic factors in patients with pancreatic cancer.胰腺癌患者的预后因素。
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