接受根治性切除术的胰腺导管腺癌患者凝血活性的预后影响。
Prognostic Impact of Coagulation Activity in Patients Undergoing Curative Resection for Pancreatic Ductal Adenocarcinoma.
机构信息
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
出版信息
In Vivo. 2020 Sep-Oct;34(5):2845-2850. doi: 10.21873/invivo.12111.
BACKGROUND/AIM: The aim of this study was to elucidate the clinical impact of coagulation disorders on outcomes after curative resection of pancreatic ductal adenocarcinoma.
PATIENTS AND METHODS
Preoperative coagulation activity in 135 patients, who had undergone curative resections for pancreatic ductal adenocarcinoma was retrospectively evaluated and the impact on survival outcomes analyzed.
RESULTS
A prolonged prothrombin time-international normalized ratio (PT-INR) (≥1.1) was detected in 23/135 patients (17%). Univariate analysis that showed prolonged PT-INR was associated with worse relapse-free (hazard ratio=1.79, p=0.044) and overall (hazard ratio=2.18, p=0.004) survival. Multivariate analyses showed prolonged PT-INR, large tumor (>30 mm), and lymph node metastasis were independent predictors of poor overall survival.
CONCLUSION
Prolonged PT-INR may be a predictor of poor prognosis in patients with pancreatic ductal adenocarcinoma who have undergone curative resection. Coagulation disorders may be a therapeutic target for improving outcomes of pancreatic ductal adenocarcinoma.
背景/目的：本研究旨在阐明凝血障碍对胰腺导管腺癌根治性切除术后结局的临床影响。
患者与方法
回顾性评估了 135 例接受胰腺导管腺癌根治性切除术患者的术前凝血活性，并分析其对生存结局的影响。
结果
135 例患者中有 23 例（17%）检测到凝血酶原时间国际标准化比值（PT-INR）延长（≥1.1）。单因素分析显示，PT-INR 延长与无复发生存（危险比=1.79，p=0.044）和总生存（危险比=2.18，p=0.004）较差相关。多因素分析显示，PT-INR 延长、肿瘤较大（>30mm）和淋巴结转移是总生存不良的独立预测因素。
结论
PT-INR 延长可能是接受根治性切除术的胰腺导管腺癌患者预后不良的预测指标。凝血障碍可能是改善胰腺导管腺癌结局的治疗靶点。
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