胰腺恶性肿瘤淋巴结清扫的研究及预后分析
发布时间：2018-11-14 12:51
【摘要】：背景本项研究比较胰头恶性肿瘤行胰十二指肠切除术后的临床及病理学各项因素情况,分析淋巴结转移数目及LNR(lymph node ratio)对患者术后生存时间的影响。通过两种不同的方法初步探索估计MNELN(Minimal Number of Examined Lymph Nodes)最小淋巴结检测数来保证胰腺恶性肿瘤的肿瘤状态可以得到准确的判断。材料与方法研究151例因胰头恶性肿瘤行胰十二指肠切除术后的患者,应用单因素及多因素分析的方法分析比较其临床病理学因素对预后的影响,包括淋巴结转移数目及LNR。根据每增长一个淋巴结检测数NELN,p N1患者在病人中的比例变化,来推测可能的MNELN最小淋巴结检测数。应用建立的二项式概率模型推算需要检测出一枚淋巴结阳性所需要的MNELN。结果患者一年总生存率70%,两年总生存率49%。平均淋巴结检测数目为7.4枚,平均阳性淋巴结数目为0.9枚。在单因素分析中发现有无淋巴结转移,LNR≥0.1,TNM分期p T情况,TNM肿瘤分期均影响术后五年生存率(P0.05)。在多因素分析中,有无淋巴结转移,与LNR≥0.1都独立地与较长的生存时间有关。生存曲线分析中,LNR≥0.1(P=0.03),LNR≥0.2(P=0.016),显著影响了患者的生存时间。随着淋巴结检测数NELN的增长,pN1病人比例的产生变化,pN1的比例在NELN达到11这个数字时有一次显著地提示,p N1比例进入了一个平台期,无明显升高趋势。应用二项概率法则得到本样本至少需要检测24枚淋巴结才能检测出一枚阳性淋巴结。结论LNR相较于淋巴结转移数目对胰头恶性肿瘤行胰十二指肠切除术后预后预测更有意义。MNELN需要更大样本量的研究才能的到更为令人信服的结果。
[Abstract]:Background to compare the clinical and pathological factors after pancreaticoduodenectomy for pancreatic head malignant tumors, and to analyze the effect of lymph node metastasis and LNR (lymph node ratio) on postoperative survival time. Two different methods were used to estimate the minimum number of lymph nodes detected by MNELN (Minimal Number of Examined Lymph Nodes) in order to ensure that the tumor status of pancreatic malignant tumors could be judged accurately. Materials and methods A total of 151 patients with malignant tumors of pancreatic head underwent pancreaticoduodenectomy. Univariate and multivariate analysis were used to compare the effect of clinicopathological factors on prognosis, including lymph node metastasis and LNR.. The possible minimum number of NELN,p N1 lymph nodes was estimated based on the percentage of patients with NELN,p N1 per increased lymph node count. Using the established binomial probability model to calculate the MNELN. needed to detect a positive lymph node Results the overall one-year survival rate was 70%, and the 2-year overall survival rate was 49%. The average number of lymph nodes detected was 7.4 and the average number of positive lymph nodes was 0.9. In univariate analysis, lymph node metastasis, LNR 鈮，
本文编号：2331205
[Abstract]:Background to compare the clinical and pathological factors after pancreaticoduodenectomy for pancreatic head malignant tumors, and to analyze the effect of lymph node metastasis and LNR (lymph node ratio) on postoperative survival time. Two different methods were used to estimate the minimum number of lymph nodes detected by MNELN (Minimal Number of Examined Lymph Nodes) in order to ensure that the tumor status of pancreatic malignant tumors could be judged accurately. Materials and methods A total of 151 patients with malignant tumors of pancreatic head underwent pancreaticoduodenectomy. Univariate and multivariate analysis were used to compare the effect of clinicopathological factors on prognosis, including lymph node metastasis and LNR.. The possible minimum number of NELN,p N1 lymph nodes was estimated based on the percentage of patients with NELN,p N1 per increased lymph node count. Using the established binomial probability model to calculate the MNELN. needed to detect a positive lymph node Results the overall one-year survival rate was 70%, and the 2-year overall survival rate was 49%. The average number of lymph nodes detected was 7.4 and the average number of positive lymph nodes was 0.9. In univariate analysis, lymph node metastasis, LNR 鈮，
本文编号：2331205
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