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目的 探讨影响胰腺癌预后的决定因素。 方法 应用流式细胞仪检测胰腺癌ＤＮＡ倍体６２ 例，采用免疫组织化学法检测ｐ２１ 、ｐ５３ 在胰腺癌中的表达，应用Ｃｏｘ 比例风险模型对其预后因素进行分析。 结果 本组共有６２ 例经手术和病理学检查证实的胰腺癌病人，其中胰腺癌患者二倍体２５ 例，四倍体１１ 例，预后较好，平均生存期分别为２８ 个月和３０ 个月，非四倍体异倍体者２６ 例平均生存期仅为５ 个月。胰腺癌组织ｐ２１ 阳性率为８９％ ，ｐ５３ 阳性率为５１％ 。二者表达均与临床分期密切相关；单因素分析发现，ＤＮＡ倍体、后腹膜浸润、手术方式、肝转移、临床分期、ｐ２１ 表达、十二指肠浸润等与预后密切相关，多因素分析中仅ＤＮＡ倍体和临床分期是独立预后决定因素。 结论 ＤＮＡ倍体和临床分期是胰腺癌独立预后的决定因素
Objective To explore the determinants of prognosis of pancreatic cancer. Methods Fifty-two cases of pancreatic cancer DNA ploidy were detected by flow cytometry. The expression of p21 and p53 in pancreatic cancer was detected by immunohistochemistry. The prognostic factors were analyzed by Cox proportional hazard model. Results A total of 62 patients with pancreatic cancer confirmed by surgery and pathology were included in the study. 25 patients were diagnosed as pancreatic cancer and 11 patients were tetraploid. The prognosis was good. The average survival time was 28 months and 30 months respectively. The average survival time of 26 non-tetraploid aneuploid patients was only 5 months. The positive rate of p21 in pancreatic cancer was 89%, and the positive rate of p53 was 51%. Both expressions were closely related to clinical stage; univariate analysis found that DNA ploidy, retroperitoneal infiltration, surgical methods, liver metastasis, clinical stage, p21 expression, duodenal infiltration, etc. were closely related to the prognosis, multivariate analysis Only DNA ploidy and clinical stage are independent prognostic factors. Conclusion DNA ploidy and clinical stage are the determinants of independent prognosis of pancreatic cancer