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目的探讨胰腺癌的手术方式、病理分期、淋巴结转移、血管侵犯对病人存活率、生存时间的影响。方法回顾性分析广东省人民医院1996年1月至2006年10月收治的50例胰腺癌病人随访资料。应用SPSS13.0统计软件包进行统计学分析。结果1、3、5年累计存活率63.0%,24.0%,12.0%,手术死亡率和术后总并发症发生率为4.0%和38.0%。COX回归分析手术方式和病理分期对生存时间及累计存活率的影响有统计学意义(P<0.05)。R0切除(根治性切除)组的中位生存时间和3、5年累计存活率分别为30个月、41.0%、20.0%,明显高于R1和R2切除组,差异具有统计学意义(P<0.05)。Ⅰ期病人3、5年累计存活率分别为49.0%、28.0%。结论早诊断、早治疗可以明显提高病人R0切除率、中位生存时间和存活率。R0切除仍是目前惟一有效、安全的治疗方法。
Objective To investigate the effects of surgery, pathological staging, lymph node metastasis and vascular invasion on the survival rate and survival time of patients with pancreatic cancer. Methods A retrospective analysis of Guangdong Provincial People’s Hospital from January 1996 to October 2006 50 cases of patients with pancreatic cancer follow-up data. SPSS13.0 statistical software package for statistical analysis. Results The cumulative survival rates at 1, 3 and 5 years were 63.0%, 24.0% and 12.0% respectively. The operative mortality and postoperative complications were 4.0% and 38.0% respectively. COX regression analysis of surgical methods and pathological stage of survival time and cumulative survival rate was statistically significant (P <0.05). The median survival time and cumulative survival rates at 3 and 5 years after R0 resection (radical resection) were 30 months, 41.0% and 20.0%, respectively, which were significantly higher than those in R1 and R2 resections (P < 0.05). The 3-year and 5-year cumulative survival rates of stage Ⅰ patients were 49.0% and 28.0% respectively. Conclusion Early diagnosis and early treatment can significantly improve the R0 resection rate, median survival time and survival rate. R0 resection is still the only effective and safe treatment.