摘要
目的通过分析原发性十二指肠腺癌(primary duodenal adenocarcinoma,PDA)患者的临床资料,探讨影响PDA患者预后的危险因素。方法收集自2009年1月—2022年12月在北京大学第一医院确诊为PDA的191例患者的临床病理资料,应用Kaplan-Meier法计算生存率并绘制生存曲线,Log-Rank检验法进行单因素分析,COX比例风险回归模型进行多因素分析得到独立危险因素。结果本组191例PDA患者的中位发病年龄为65岁,最常见的主诉为腹痛、腹胀不适。预后分析显示患者的1、3、5年生存率分别为73.8%、44.6%、23.0%。COX风险比例回归模型分析表明术前血清CA19-9水平、肿瘤浸润深度、分化程度、TNM分期、手术方式是影响PDA患者预后的独立危险因素(均P<0.01)。结论PDA总体发病率较低,但是预后不佳,多种因素影响其预后,手术治疗是治愈的重要手段。
Objective By analyzing the clinical data of patients with primary duodenal adenocarcinoma(PDA),the risk factors affecting the postoperative prognosis of PDA patients were discussed.Methods The clinical data of 191 patients diagnosed with PDA in Peking University First Hospital from Jan 2009 to Dec 2022 were collected.The survival rate was calculated and the survival curve was plotted by Kaplan-Meier method.Univariate analysis was performed by Log-Rank test,and multivariate analysis was performed by COX proportional hazards regression model to obtain independent risk factors.Results The median age of onset in patients with PDA is 65 years old,and the most common symptoms are abdominal pain and abdominal distension.Prognostic analysis showed that the survival rates at 1,3 and 5 years were 73.8%,44.6%,and 23.0%.The analysis of Cox risk proportional regression model showed that preoperative CA19-9 level,depth of tumor invasion,degree of differentiation,TNM stage,and surgical mode were independent risk factors for the prognosis of PDA(all P<0.01).Conclusion The overall incidence of PDA is low,but the prognosis is rather poor.Multvariable factors are associated with its prognosis and surgery is still the mainstay for hope of cure.
作者
王文杰
张峻岭
郑航
武颖超
姜勇
王鹏远
陈国卫
吴涛
刘天野
张继新
汪欣
Wang Wenjie;Zhang Junling;Zheng Hang;Wu Yingchao;Jiang Yong;Wang Pengyuan;Chen Guowei;Wu Tao;Liu Tianye;Zhang Jixin;Wang Xin(Department of Gastrointestinal Surgery,Peking University First Hospital,Beijing 100034,China;Medical Records and Clinical Data Centre,Peking University First Hospital,Beijing 100034,China;Department of Pathology,Peking University First Hospital,Beijing 100034,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2023年第8期582-588,共7页
Chinese Journal of General Surgery
基金
国家重大疾病多学科合作诊疗能力建设项目
北京市中医药科技发展资金项目(JJ2018-05)
国家自然科学基金(81641098)
深圳市三名工程项目
北京大学第一医院青年临床研究专项基金(2021CR03)
北京大学第一医院科研种子基金(2018SF090)
北京大学医学部青年培育基金(BMU2020PYB026)。
关键词
十二指肠肿瘤
腺癌
病理学
临床
预后
Duodenal neoplasms
Adenocarcinoma
Pathology,clinical
Prognosis
