CAJ | 학술논문

目的探讨影响原发性十二指肠乳头癌预后的因素.方法回顾性分析1995年6月至2005年6月厦门大学附属东南医院收治的73例原发性十二指肠乳头癌患者的临床资料.对患者性别、年龄、有无黄疸、肿瘤直径、病程时间、TBil、肿瘤分化程度、有无淋巴结转移、手术方式以及根治程度等10个因素采用Log-rank检验进行单因素分析,再采用Cox多因素回归模型进行多因素分析.生存时间用中位数表示,Kaplan-Meier法绘制生存曲线.结果本组患者中位生存时间为34个月.患者年龄、有无黄疸、肿瘤直径、病程时间、TBil、肿瘤分化程度、有无淋巴结转移、手术方式及根治程度与预后密切相关(x2=18.315,4.562,7.989,10.660,11.138,7.995,5.423,114.464,83.383,P＜0.05);而患者性别与预后无关(x2 =1.720,P＞0.05).肿瘤分化程度、手术方式及根治程度是影响患者预后生存的独立因素(RR=2.039,2.178,5.798,P＜0.05).结论肿瘤分化程度、手术方式及根治程度是影响十二指肠乳头癌预后生存的独立因素,标准手术方式的选择及根治程度对患者预后具有重要影响.
목적 탐토영향원발성십이지장유두암예후적인소.방법 회고성분석1995년6월지2005년6월하문대학부속동남의원수치적73례원발성십이지장유두암환자적림상자료.대환자성별、년령、유무황달、종류직경、병정시간、TBil、종류분화정도、유무림파결전이、수술방식이급근치정도등10개인소채용Log-rank검험진행단인소분석,재채용Cox다인소회귀모형진행다인소분석.생존시간용중위수표시,Kaplan-Meier법회제생존곡선.결과 본조환자중위생존시간위34개월.환자년령、유무황달、종류직경、병정시간、TBil、종류분화정도、유무림파결전이、수술방식급근치정도여예후밀절상관(x2=18.315,4.562,7.989,10.660,11.138,7.995,5.423,114.464,83.383,P＜0.05);이환자성별여예후무관(x2 =1.720,P＞0.05).종류분화정도、수술방식급근치정도시영향환자예후생존적독립인소(RR=2.039,2.178,5.798,P＜0.05).결론 종류분화정도、수술방식급근치정도시영향십이지장유두암예후생존적독립인소,표준수술방식적선택급근치정도대환자예후구유중요영향.
Objective To study the prognostic factors of primary duodenal papilla carcinoma.Methods The clinical data of 73 patients with primary duodenal papilla carcinoma who were admitted to the Dongnan Hospital of Xiamen University from June 1995 to June 2005 were retrospectively analyzed.Ten factors including gender,age,jaundice,tumor size,course of disease,total bilirubin,tumor differentiation,lymphatic metastasis,type of surgery and degree of resection were analyzed by Log-rank test.Prognostic factors with significant difference were further analyzed by the Cox regression model.The survival curve was drawn by using the Kaplan-Meier method.Results The median survival time of the patients was 34 months.Age,jaundice,tumor size,course of disease,total bilirubin,tumor differentiation,lymphatic metastasis,type of surgery and degree of resection were correlated with the prognosis (x2 =18.315,4.562,7.989,10.660,11.138,7.995,5.423,114.464,83.383,P＜0.05),while no significant difference was found between gender and prognosis ( x2 =1.720,P ＞ 0.05 ).Multivariate analysis demonstrated that tumor differentiation,type of surgery and degree of resection were the factors influencing the prognosis of patients with duodenal papilla carcinoma (RR =2.039,2.178,5.798,P＜0.05).Conclusions Tumor differentiation,type of surgery and degree of resection are the dependent factors influencing the prognosis of patients with duodenal papilla carcinoma.The standard type of surgery and degree of resection are important for the prognosis of patients.