胰腺癌术后肝转移影响因素的Logistic回归分析_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 李琦 , 张华秦 , 吴海斌

陕西省延安市人民医院肝胆外科（陕西延安 716000）;

Corresponding author：

李琦, Email: liqi627@126.com

Keywords：

胰腺癌; 手术; 肝转移; 影响因素

DOI：

10.7507/1007-9424.20160126

Video：

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目的探讨胰腺癌术后肝转移的影响因素。方法回顾性分析2004年3月至2014年3月期间笔者所在医院136例胰腺癌手术患者的临床资料。采用卡方检验进行胰腺癌手术后肝转移影响因素的单因素分析，采用多因素Logistic回归分析进行独立危险因素分析。结果单因素分析结果显示：年龄、体质量指数（BMI）、是否合并脂肪肝、发病至确诊时间、是否有脉管癌栓、浸润深度、组织学分级及术后是否化疗是胰腺癌术后肝转移的影响因素（P＜0.05）；多因素Logistic回归分析结果显示：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）、发病至确诊时间（OR=1.673，95% CI=1.097～2.354，P=0.005）、是否有脉管癌栓（OR=3.263，95% CI 1.514～5.652，P=0.001）及组织学分级（OR=4.239，95% CI=2.943～6.907，P=0.000）是胰腺癌手术后肝转移的独立影响因素。结论肥胖、发病至确诊时间长、有脉管癌栓及中低分化癌是胰腺癌术后肝转移的危险因素，而术前合并脂肪肝是胰腺癌患者术后肝转移的保护性因素。

Citation： 李琦, 张华秦, 吴海斌. 胰腺癌术后肝转移影响因素的Logistic回归分析. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 478-481. doi: 10.7507/1007-9424.20160126 Copy

1.	孟泽武, 陈燕凌, 韩圣华, 等.胰腺癌术后肝转移的危险因素分析.中华肿瘤杂志, 2015, 37(4):312-316.
2.	孙备, 陈华.胰腺癌伴肝转移行全胰十二指肠切除术一例.中华外科杂志, 2014, 52(9):653-654.
3.	李泽朝, 罗诗樵.胰腺癌肝转移长期生存1例.中国普通外科杂志, 2014, 23(3):402-403.
4.	李泽朝, 罗诗樵.胰腺恶性肿瘤肝转移综合治疗现状.中国实用外科杂志, 2014, 34(3):270-272.
5.	欧阳华强, 潘战, 谢广茹, 等.胰腺癌肝转移治疗进展.中国肿瘤临床, 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.	祝鹏, 刘慧颖, 姚骏, 等.胰腺癌肝转移与循环肿瘤细胞上皮-间质转化表型的关系.肿瘤, 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, 盛伟伟.胰腺癌术后肝转移的临床病理学特点.中国医科大学学报, 2015, 44(7):644-647.
16.	Bolm L, Janssen S, Käsmann L, et al. Predicting survival after irradiation of metastases from pancreatic cancer. Anticancer Res, 2015, 35(7):4105-4108.

1. 孟泽武, 陈燕凌, 韩圣华, 等.胰腺癌术后肝转移的危险因素分析.中华肿瘤杂志, 2015, 37(4):312-316.
2. 孙备, 陈华.胰腺癌伴肝转移行全胰十二指肠切除术一例.中华外科杂志, 2014, 52(9):653-654.
3. 李泽朝, 罗诗樵.胰腺癌肝转移长期生存1例.中国普通外科杂志, 2014, 23(3):402-403.
4. 李泽朝, 罗诗樵.胰腺恶性肿瘤肝转移综合治疗现状.中国实用外科杂志, 2014, 34(3):270-272.
5. 欧阳华强, 潘战, 谢广茹, 等.胰腺癌肝转移治疗进展.中国肿瘤临床, 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. 祝鹏, 刘慧颖, 姚骏, 等.胰腺癌肝转移与循环肿瘤细胞上皮-间质转化表型的关系.肿瘤, 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, 盛伟伟.胰腺癌术后肝转移的临床病理学特点.中国医科大学学报, 2015, 44(7):644-647.
16. Bolm L, Janssen S, Käsmann L, et al. Predicting survival after irradiation of metastases from pancreatic cancer. Anticancer Res, 2015, 35(7):4105-4108.

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胰腺癌术后肝转移影响因素的Logistic回归分析

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