胰腺癌術后肝轉移影響因素的Logistic回歸分析_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 李琦 , 張華秦 , 吳海斌

陜西省延安市人民醫院肝膽外科（陜西延安 716000）;

Corresponding?author：

李琦, Email: liqi627@126.com

Keywords：

胰腺癌; 手術; 肝轉移; 影響因素

DOI：

10.7507/1007-9424.20160126

Video：

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目的探討胰腺癌術后肝轉移的影響因素。方法回顧性分析2004年3月至2014年3月期間筆者所在醫院136例胰腺癌手術患者的臨床資料。采用卡方檢驗進行胰腺癌手術后肝轉移影響因素的單因素分析，采用多因素Logistic回歸分析進行獨立危險因素分析。結果單因素分析結果顯示：年齡、體質量指數（BMI）、是否合并脂肪肝、發病至確診時間、是否有脈管癌栓、浸潤深度、組織學分級及術后是否化療是胰腺癌術后肝轉移的影響因素（P＜0.05）；多因素Logistic回歸分析結果顯示：BMI（OR=2.824，95% CI=1.293～3.784，P=0.002）、是否合并脂肪肝（OR=2.709，95% CI=1.126～3.263，P=0.003）、發病至確診時間（OR=1.673，95% CI=1.097～2.354，P=0.005）、是否有脈管癌栓（OR=3.263，95% CI 1.514～5.652，P=0.001）及組織學分級（OR=4.239，95% CI=2.943～6.907，P=0.000）是胰腺癌手術后肝轉移的獨立影響因素。結論肥胖、發病至確診時間長、有脈管癌栓及中低分化癌是胰腺癌術后肝轉移的危險因素，而術前合并脂肪肝是胰腺癌患者術后肝轉移的保護性因素。

Citation： 李琦, 張華秦, 吳海斌. 胰腺癌術后肝轉移影響因素的Logistic回歸分析. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 478-481. doi: 10.7507/1007-9424.20160126 Copy

1.	孟澤武, 陳燕凌, 韓圣華, 等.胰腺癌術后肝轉移的危險因素分析.中華腫瘤雜志, 2015, 37(4):312-316.
2.	孫備, 陳華.胰腺癌伴肝轉移行全胰十二指腸切除術一例.中華外科雜志, 2014, 52(9):653-654.
3.	李澤朝, 羅詩樵.胰腺癌肝轉移長期生存1例.中國普通外科雜志, 2014, 23(3):402-403.
4.	李澤朝, 羅詩樵.胰腺惡性腫瘤肝轉移綜合治療現狀.中國實用外科雜志, 2014, 34(3):270-272.
5.	歐陽華強, 潘戰, 謝廣茹, 等.胰腺癌肝轉移治療進展.中國腫瘤臨床, 2014, 41(2):138-141.
6.	Cannistrà M, Ruggiero M, Zullo A, et al. Metastases of pancreatic adenocarcinoma:A systematic review of literature and a new functional concept. Int J Surg, 2015, 6(26):873-876.
7.	祝鵬, 劉慧穎, 姚駿, 等.胰腺癌肝轉移與循環腫瘤細胞上皮-間質轉化表型的關系.腫瘤, 2015, 35(8):874-882.
8.	Tafuto S, von Arx C, De Divitiis C, et al. Electrochemotherapy as a new approach on pancreatic cancer and on liver metastases. Int J Surg, 2015, 6(27):382-385.
9.	Ray K. Pancreatic cancer:Pancreatic cancer exosomes prime the liver for metastasis. Nat Rev Gastroenterol Hepatol, 2015, 12(7):371-375.
10.	Costa-Silva B, Aiello NM, Ocean AJ, et al. Pancreatic cancer exosomes initiate pre-metastatic niche formation in the liver. Nat Cell Biol, 2015, 17(6):816-826.
11.	Peixoto RD, Speers C, McGahan CE, et al. Prognostic factors and sites of metastasis in unresectable locally advanced pancreatic cancer. Cancer Med, 2015, 4(18):1028-1033.
12.	Han Y, Ru GQ, Mou X, et al. AUTS2 is a potential therapeutic target for pancreatic cancer patients with liver metastases. Med Hypotheses, 2015, 3(1):920-923.
13.	Nakayama A1, Tajima H, Kitagawa H, et al. A case report of hepatic arterial infusion chemotherapy and RFA for liver metastasis from pancreatic cancer. Gan To Kagaku Ryoho, 2014, 41(12):2205-2207.
14.	Kawamoto T, Hishima T, Kimura K, et al. Calcified liver metastases from a non-functioning pancreatic neuroendocrine tumor. Clin J Gastroenterol, 201, 7(5):460-464.
15.	高威, 盛偉偉.胰腺癌術后肝轉移的臨床病理學特點.中國醫科大學學報, 2015, 44(7):644-647.
16.	Bolm L, Janssen S, K?smann L, et al. Predicting survival after irradiation of metastases from pancreatic cancer. Anticancer Res, 2015, 35(7):4105-4108.

1. 孟澤武, 陳燕凌, 韓圣華, 等.胰腺癌術后肝轉移的危險因素分析.中華腫瘤雜志, 2015, 37(4):312-316.
2. 孫備, 陳華.胰腺癌伴肝轉移行全胰十二指腸切除術一例.中華外科雜志, 2014, 52(9):653-654.
3. 李澤朝, 羅詩樵.胰腺癌肝轉移長期生存1例.中國普通外科雜志, 2014, 23(3):402-403.
4. 李澤朝, 羅詩樵.胰腺惡性腫瘤肝轉移綜合治療現狀.中國實用外科雜志, 2014, 34(3):270-272.
5. 歐陽華強, 潘戰, 謝廣茹, 等.胰腺癌肝轉移治療進展.中國腫瘤臨床, 2014, 41(2):138-141.
6. Cannistrà M, Ruggiero M, Zullo A, et al. Metastases of pancreatic adenocarcinoma:A systematic review of literature and a new functional concept. Int J Surg, 2015, 6(26):873-876.
7. 祝鵬, 劉慧穎, 姚駿, 等.胰腺癌肝轉移與循環腫瘤細胞上皮-間質轉化表型的關系.腫瘤, 2015, 35(8):874-882.
8. Tafuto S, von Arx C, De Divitiis C, et al. Electrochemotherapy as a new approach on pancreatic cancer and on liver metastases. Int J Surg, 2015, 6(27):382-385.
9. Ray K. Pancreatic cancer:Pancreatic cancer exosomes prime the liver for metastasis. Nat Rev Gastroenterol Hepatol, 2015, 12(7):371-375.
10. Costa-Silva B, Aiello NM, Ocean AJ, et al. Pancreatic cancer exosomes initiate pre-metastatic niche formation in the liver. Nat Cell Biol, 2015, 17(6):816-826.
11. Peixoto RD, Speers C, McGahan CE, et al. Prognostic factors and sites of metastasis in unresectable locally advanced pancreatic cancer. Cancer Med, 2015, 4(18):1028-1033.
12. Han Y, Ru GQ, Mou X, et al. AUTS2 is a potential therapeutic target for pancreatic cancer patients with liver metastases. Med Hypotheses, 2015, 3(1):920-923.
13. Nakayama A1, Tajima H, Kitagawa H, et al. A case report of hepatic arterial infusion chemotherapy and RFA for liver metastasis from pancreatic cancer. Gan To Kagaku Ryoho, 2014, 41(12):2205-2207.
14. Kawamoto T, Hishima T, Kimura K, et al. Calcified liver metastases from a non-functioning pancreatic neuroendocrine tumor. Clin J Gastroenterol, 201, 7(5):460-464.
15. 高威, 盛偉偉.胰腺癌術后肝轉移的臨床病理學特點.中國醫科大學學報, 2015, 44(7):644-647.
16. Bolm L, Janssen S, K?smann L, et al. Predicting survival after irradiation of metastases from pancreatic cancer. Anticancer Res, 2015, 35(7):4105-4108.

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胰腺癌術后肝轉移影響因素的Logistic回歸分析

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