Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas.
Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas.
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DOI：
10.1038/sj.bjc.6602305
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发表时间：
2005-01-17
影响因子：
8.8
通讯作者：
中科院分区：
文献类型：
--
作者：
本研究的目的是研究接受可能治愈的胰腺头部导管腺癌切除术的患者的临床病理状态、术前和术后全身炎症反应与生存之间的关系。研究纳入了1993年至2001年间行胰头导管腺癌切除术的患者（n=65），并进行了术前和术后c反应蛋白测量。大多数患者为III期疾病（国际抗癌联盟标准，IUCC），阳性周缘受累（R1），肿瘤大小大于25mm，伴神经周围和淋巴结浸润，并在随访期间死亡。在多因素分析中，肿瘤大小（风险比（HR） 2.10, 95%可信区间（CI） 1.20-3.68， P=0.009）、血管侵犯（HR 2.58, 95% CI 1.48-4.50， P<0.001）和术后c反应蛋白（HR 2.00, 95% CI 1.14-3.52， P=0.015）保持独立显著性。术后c -反应蛋白≥10 mg l - 1的患者中位生存期为21.5个月，而c -反应蛋白≥10 mg l - 1的患者中位生存期为8.4个月（P<0.001）。本研究的结果表明，在接受有可能治愈的胰腺头部导管腺癌切除术的患者中，全身性炎症反应的存在预示着预后不良。
The aim of the present study was to examine the relationship between the clinicopathological status, the pre- and postoperative systemic inflammatory response and survival in patients undergoing potentially curative resection for ductal adenocarcinoma of the head of the pancreas. Patients (n=65) who underwent resection of ductal adenocarcinoma of the head of pancreas between 1993 and 2001, and had pre- and postoperative measurements of C-reactive protein, were included in the study. The majority of patients had stage III disease (International Union Against Cancer Criteria, IUCC), positive circumferential margin involvement (R1), tumour size greater than 25 mm with perineural and lymph node invasion and died within the follow-up period. On multivariate analysis, tumour size (hazard ratio (HR) 2.10, 95% confidence interval (CI) 1.20–3.68, P=0.009), vascular invasion (HR 2.58, 95% CI 1.48–4.50, P<0.001) and postoperative C-reactive protein (HR 2.00, 95% CI 1.14–3.52, P=0.015) retained independent significance. Those patients with a postoperative C-reactive protein ⩽10 mg l−1 had a median survival of 21.5 months compared with 8.4 months in those patients with a C-reactive protein >10 mg l−1 (P<0.001). The results of the present study indicate that, in patients who have undergone potentially curative resection for ductal adenocarcinoma of the head of pancreas, the presence of a systemic inflammatory response predicts poor outcome.
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