转移淋巴结数目对胰腺癌患者预后的意义

摘要

目的 探讨胰腺导管细胞癌患者术后病理证实的转移淋巴结数目与预后的关系.方法 回顾性收集149例胰腺导管细胞癌患者术后临床病理资料并随访预后;统计分析转移淋巴结数目与预后的关系.结果 本组患者中位随访时间13个月(1～ 86个月),失访率0.67％ (1/149),围手术期死亡率2.7％(4/149).清扫淋巴结中位数为10.5个(0～33个),其中转移淋巴结中位数是2个(1～17个).患者中位生存期和平均生存期分别为13个月和20.8个月,术后1年、3年及5年生存率分别为54.6％,16.5％及9.1％.单因素分析发现:术后淋巴结转移,淋巴结转移率及转移淋巴结数目(0,1～7个,8个及以上)均与患者预后显著相关.COX回归多因素分析发现以上因素中仅转移淋巴结数目是患者预后的独立危险因素.结论 转移淋巴结数目,而非淋巴结转移率,是胰腺癌患者预后的独立危险因素.%Objective To investigate the prognostic significance of the number of metastatic lymph nodes after resection of pancreatic ductal adenocarcinoma.Methods The clinicopathologic data were collected retrospectively from 149 pancreatic ductal adenocarcinoma patients undergoing tumor resection.Routine follow-up was done by outpatient interview or telephone.Results During the median follow-up of 13 months (1-86 months),the loss rate was 0.67％ (1/149) and the postoperative mortality was 2.7％ (4/149),the median dissected lymph nodes was 10.5 (range 0-33),and the median metastatic lymph nodes was 2 (range 1-17).The median and mean survival time were 13 months and 20.8 months respectively,and the postoperative 1-year,3-year and 5-year survival rate were 54.6％,16.5％ and 9.1％ respectively.Univariate analysis revealed that postoperative lymph node metastasis,metastatic lymph node ratio (LNR),and the number of metastatic lymph nodes (0,1-7,≥ 8) predicted poor survival.Multivariate COX regression analysis demonstrated that only the number of metastatic lymph nodes (0,1-7,≥8) was the independent prognostic risk factor.Conclusions The number of metastatic lymph nodes,not the metastatic lymph node ratio (LNR),was an independent prognostic factor after resection of pancreatic ductal adenocarcinoma.