摘要
目的:拟在术前建立一套数学模型,以期为可切除性胰腺癌患者的治疗决策提供参考依据。方法:回顾性分析2011年1月至2018年6月收治的符合研究标准的120例可切除性胰腺导管腺癌(PDAC)患者的临床资料。以SAS 9.4(Cary,NC)对数据进行统计学分析,预后风险因素进行单因素分析后将有统计学意义的因素纳入Logistic多因素回归分析,确定胰腺癌预后不良的独立危险因素,进而拟合建立胰腺癌不良预后(<20个月)风险预测模型。以P<0.05为差异具有统计学意义。结果:单因素及多因素Logistics回归分析后显示,系统免疫炎症指数(SIII)、糖类抗原CA19-9(CA19-9)、肿瘤大小是胰腺癌预后不良(<20个月)的独立危险因素(P<0.05);拟合后得到胰腺癌不良预后预测公式模型:Log(p/1-p)=-5.825+0.004×SIII+0.002×CA19-9+0.822×肿瘤大小;训练组曲线下面积为0.872(95%CI:0.797-0.946),P<0.001,灵敏度为0.824,特异度为0.818;模型Hosmer-Lemeshow拟合优度检验χ^(2)=3.031,P=0.932。结论:本预测模型可在术前对可切除性PDAC患者预后生存期进行评判,同时对可切除性PDAC进行筛选,从而为患者治疗决策提供一定的参考。
Objective A mathematical model was established before operation to provide reference for treatment decision of patients with resectable pancreatic cancer.Method The clinical data of 120 patients with resectable pancreatic ductal adenocarcinoma(PDAC)who met the study criteria and were admitted from January 2011 to June 2018 were retrospectively analyzed.The patients'clinical data were divided into two groups with high and low survival,with the survival period less than 20 months as the limit.Statistical analysis was performed using SAS 9.4(Cary,NC),univariate analysis and multivariate regression analysis were used by Log-Rank method to determine independent risk factors for poor prognosis of pancreatic cancer,and then a risk prediction model for poor prognosis of pancreatic cancer(<20 months)was established.P<0.05 was considered to be statistically significant.Results Univariate and multifactorial Logistic regression analysis showed that SIII,CA19-9 and tumor size were independent risk factors for poor prognosis of pancreatic cancer(<20 months)(P<0.05).After fitting,the formula model for predicting adverse prognosis of pancreatic cancer was obtained:Log(p/1-p)=-5.825+0.004×SIII+0.002×CA199+0.822×tumor size;The area under the training suite was 0.872(95%CI 0.7977-0.946),P<0.001,sensitivity was 0.824,specificity was 0.818;Hosmer-Lemeshow goodness of fit testχ^(2)=3.031,P=0.932.Conclusions This prediction model can evaluate the prognosis and survival of patients with resectable PDAC before surgery,and at the same time screen resectable PDAC,so as to provide a certain reference for the treatment decision of patient.
作者
贾成朋
王代宏
陈华
孙备
Jia Chengpeng;Wang Daihong;Chen Hua;Sun Bei(Department of Hepatobiliary and Pancreatic Surgery,Xianning Central Hospital,Xianning Hubei Province 437100,China;Department of Pancreaticobiliary Surgery,The First Affiliated Hospital of Harbin Medical University,Key Laboratory of Hepatosplenic Surgery Ministry of Education,Harbin Heilongjiang Province 150001,China)
出处
《中华普外科手术学杂志（电子版）》
2023年第5期566-570,共5页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
胰腺肿瘤
预后
肿瘤大小
系统免疫炎症指数
预测模型
Pancreatic Neoplasms
Prognosis
Tumor Size
Systemic Immune Inflammation Index
Prediction Model
