中国实用外科杂志2011，Vol.31Issue(12)：1117-1120,4.
胰头癌肿瘤分期影响因素分析
Analysis of clinical factors associating with improvement of TNM staging accuracy in pancreatic head adenocarcinoma
徐威 1李敬东 1赵国刚 1田云鸿1
作者信息
- 1. 川北医学院附属医院普通外科肝胆肠胰疾病研究所,四川南充 637000
- 折叠
摘要
Abstract
Objective To explore possible clinical factors contributing to improvement of TNM staging accuracy in pancreatic head adenocarcinoma (PHA). Methods The retrospective study was conducted on 121 consecutive cases of PHA surgically treated from January 2004 to December 2010 in Affiliated Hospital of North Sichuan Medical College. Univariate and multivariate analysis using ordinal logistic regression explored clinical factors relating to postoperative tumor staging (Ptnm staging). Cross-validation was done to test discriminant accuracy of multivariate analysis results when compared with preoperatively radiologically TNM staging evaluation. Results Altogether 121 cases of potentially-resectable PHA entered the study. Preoperatively radiologically TNM staging evaluation revealed as followed: unidentified: 28 cases (23.1%), IA 9 cases (7.4%),IB 45 cases (37.2%), HA 18 cases (14.9%),IIB 15 cases (12.4%) and HI 6 cases (5.0%), respectively. Simple radiological TNM staging accuracy was frustrating, since Ptnm staging results as followed: IA 2 cases (1.7%) , IB 7 cases (5.8%), HA 14 cases (11.6%), IIB 6 cases (5.0%), III 63 cases (52.1%) and IV 29 cases (24.0%) , respectively. Multivariate analysis demonstrated that radiologically TNM staging, tumor diameters, ALT≥84.6U/L, neutrophil-lymphocyte ratio and serum CA19-9 values contributed to improvement of accurate TNM staging. Cross-validation based on multivariate results exhibited better discriminant performance, demonstrating the number of observations correctly classified as 71.7% and 66.7% of cross-validated grouped cases correctly classified. When Ptnm staging reclassified three categories as IA + IB + IIA + IIB.III and IV, 78.6% of original grouped cases correctly classified and 74.6% of cross-validated grouped cases correctly classified. Conclusion Clinical factors associating with TNM staging could improve accuracy of PHA TNM staging and may be incorporated into current management strategy for PHA.关键词
胰头癌/肿瘤分期/多因素分析Key words
pancreatic head carcinoma/ tumor staging/ multivariate analysis分类
医药卫生引用本文复制引用
徐威,李敬东,赵国刚,田云鸿..胰头癌肿瘤分期影响因素分析[J].中国实用外科杂志,2011,31(12):1117-1120,4.
