■探讨胰腺导管腺癌(PDAC)根治性切除术患者的基线临床特征和血液学参数与预后的关系。并为患者临床风险分层提供参考。
我们回顾性收集了在华西医院接受PDAC根治性手术治疗的445例患者的临床资料,四川大学2010年1月至2019年2月。然后,我们对收集的数据进行了回顾性临床分析.关于患者基本临床特征的数据,血常规检查结果,收集肿瘤指标,探讨其对PDAC患者术后总生存期(OS)的影响。Cox比例风险回归用于确定影响OS的因素。采用SPSS23.0软件包进行统计学分析。
■术后中位总生存期(mOS)为17.0个月(95%CI:15.0-19.0)。纳入研究的患者的1、2、3、4和5年生存率为60.6%,33.4%,19.1%,12.7%,9.6%,分别。多变量Cox比例风险模型分析表明,许多因素独立影响PDAC患者的术后生存率。这些因素包括肿瘤位置(危险比[HR]=1.574,95%CI:1.233-2.011),肿瘤细胞分化程度(HR=0.687,95%CI:0.542-0.870),存在神经浸润(HR=0.686,95%CI:0.538-0.876),TNM分期(HR=1.572,95%CI:1.252-1.974),术后辅助治疗(HR=1.799,95%CI:1.390-2.328),术前饮酒史(HR=0.744,95%CI:0.588-0.943),术前血清CA199水平较高(HR=0.742,95%CI:0.563-0.977)。
■在PDAC患者中,胰腺头部有肿瘤,中度和高度分化,没有局部神经血管侵犯,处于TNM第一阶段,接受术后辅助治疗,手术前没有饮酒史,术前血清CA199小于或等于37U/mL与更好的预后显著相关。
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.