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目的 :研究胰头恶性肿瘤行胰十二指肠切除术后,淋巴结转移数及淋巴结转移率(lymph node ratio,LNR)对生存时间的影响。方法:151例病人因胰头导管腺癌行胰十二指肠切除术,应用单因素及多因素分析的方法研究比较临床病理学因素对预后的影响,包括淋巴结转移数及LNR。结果:病人1、2年总生存率分别为70.3%和49.7%,5年78例总生存率15.4%。平均淋巴结检测数目为(7.4±5.7)枚,平均阳性淋巴结数目为(0.9±1.7)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和总分期均影响术后5年生存率(P<0.05)。在多因素分析中,有无淋巴结转移,与LNR≥0.1都独立地与5年生存时间有关。生存曲线分析中,LNR≥0.1(P=0.03),LNR≥0.2(P=0.016),显著影响病人的生存时间。结论 :相比于淋巴结转移数,LNR对胰头恶性肿瘤行胰十二指肠切除术后病人生存的预测更有意义。
Objective: To study the effect of lymph node ratio (LNR) on the survival time of patients with pancreatic head malignancies after pancreaticoduodenectomy. METHODS: One hundred and fifteen patients undergoing pancreatoduodenectomy for pancreaticoduodenectomy underwent pancreaticoduodenectomy. Univariate and multivariate analyzes were performed to compare the effects of clinicopathological factors on prognosis, including lymph node metastasis and LNR. Results The overall 1-year and 2-year survival rates of patients were 70.3% and 49.7%, respectively. The overall survival rate of 78 patients in 5 years was 15.4%. The average number of lymph nodes detected (7.4 ± 5.7) pieces, the average number of positive lymph nodes (0.9 ± 1.7) pieces. In univariate analysis, LNM≥0.1, pT and TNM stage were all found to affect the 5-year survival rate (P <0.05). In multivariate analysis, there was no lymph node metastasis, independent of LNR≥0.1 and 5-year survival time. In survival curve analysis, LNR≥0.1 (P = 0.03) and LNR≥0.2 (P = 0.016), which significantly affected the survival time of patients. CONCLUSIONS: Compared with lymph node metastasis, LNR is more meaningful for the prognosis of patients with pancreatic cancer after pancreatoduodenectomy.