CAJ | 학술논문

目的研究影响远端胆管癌手术预后的因素,为远端胆管癌手术方式的选择和治疗提供依据.方法对北京世纪坛医院、北京大学人民医院和北京大学第一医院1995-2009年具有完整随访资料的103例远端胆管癌病例进行回顾性分析,应用Kaplan-Meier单因素分析法和Cox比例风险模型多因素分析法对10个可能对预后产生影响的因素进行分析.结果 1、3、5年总体生存率分别为72%、41%和25%,中位生存期为24.13个月;单因素方差分析结果表明手术方式、淋巴结转移、TNM分期和切缘情况与远端胆管癌术后生存有关;Cox比例风险模型多因素分析结果表明切缘情况、淋巴结转移和TNM分期是影响远端胆管癌切除术后预后的独立因素.结论切缘情况、淋巴结转移和TNM分期为远端胆管癌切除术后有关生存影响的独立因素,胰十二指肠切除术为远端胆管癌首选的手术方式.
목적 연구영향원단담관암수술예후적인소,위원단담관암수술방식적선택화치료제공의거.방법 대북경세기단의원、북경대학인민의원화북경대학제일의원1995-2009년구유완정수방자료적103례원단담관암병례진행회고성분석,응용Kaplan-Meier단인소분석법화Cox비례풍험모형다인소분석법대10개가능대예후산생영향적인소진행분석.결과 1、3、5년총체생존솔분별위72%、41%화25%,중위생존기위24.13개월;단인소방차분석결과표명수술방식、림파결전이、TNM분기화절연정황여원단담관암술후생존유관;Cox비례풍험모형다인소분석결과표명절연정황、림파결전이화TNM분기시영향원단담관암절제술후예후적독립인소.결론 절연정황、림파결전이화TNM분기위원단담관암절제술후유관생존영향적독립인소,이십이지장절제술위원단담관암수선적수술방식.
Objective To study prognostic factors after surgical resection for distal bile duct cancer. Methods A retrospective muhicenter clinical analysis,including Beijing Shijitan Hospital,Peking University People's Hospital and Peking University First Hospital,was made for 103 patients of distal bile duct cancer receiving surgical resection from 1995 to 2009.Potential clinicopathological prognostic factors were examined bv univariate and multivariate survival analysis. Results The 1.3 and 5 years overall survival rate was 72%,41%and 25% respectively (median survival time,24.13 months).Univariate analysis revealed operative modality,lymph node status,surgical margin and TNM stage as significant factors influencing postoperative survival.Positive surgical margin,lymph node metastasis and TNM stage were significant independent predictors of poor prognosis by a Cox proportional hazards regression model. Condusions Surgical margin margin,lymph node metastasis and TNM stage were the most important prognostic factors for bile duct carcinoma after resection.Radical pancreaticoduodenectomy was the choice of therapy for distal bile duct carcinoma.