Prognostic Factors and Clinical Characteristics of Duodenal Adenocarcinoma With Survival: A Retrospective Study.
Prognostic Factors and Clinical Characteristics of Duodenal Adenocarcinoma With Survival: A Retrospective Study.
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十二指肠腺癌生存的预后因素和临床特征：一项回顾性研究。
DOI：
10.3389/fonc.2021.795891
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发表时间：
2021
影响因子：
4.7
通讯作者：
Gong W
中科院分区：
文献类型：
--
作者：
Sun H;Liu Y;Lv L;Li J;Liao X;Gong W
评估影响十二指肠腺癌（DA）患者肿瘤切除后总生存的临床危险因素。本研究回顾性分析了2005年1月至2020年6月在襄阳市中心医院接受DA肿瘤切除术的188例患者。接受切除手术的患者的中位生存期为 54 个月，长于接受姑息性手术的患者（20.8 个月）（2,916.17；95% CI，916.3−9,280.5；p < 0.001）。非壶腹十二指肠癌患者的生存期（50.3个月；95% CI，39.7−61.8）与壶腹十二指肠癌患者的生存期（59.3个月；95% CI，38.6−66.7）相似，但明显优于乳头状腺癌患者（38.9个月；95% CI，29.8−54.8；p） = 0.386）。肠型导管腺癌患者的中位总生存期比胃型导管腺癌患者（61.8 个月与 46.7 个月；p < 0.01）或胰腺型导管腺癌患者（32.2 个月；p < 0.001）更长。临床 DA 样本中 ATG12、IRS2 和 IGF2 的表达存在显着差异。 ATG12 和 IRS2 蛋白的较高表达与较差的生存率显着相关。多变量 Cox 回归分析显示淋巴结转移（风险比 (HR)，6.44；95% CI，3.68−11.27；p < 0.0001）、切缘状态（HR，4.94；95% CI，2.85−8.54；p < 0.0001）和 ATG12 高表达（HR，1.89；95%） CI，1.17−3.06；p = 0.0099）是与接受根治性切除的患者的生存呈负相关的独立预后因素。接受辅助化疗的壶腹、非壶腹和乳头状腺癌组之间没有生存率差异（p = 0.973）。与具有肿瘤解剖位置的患者相比，胃/胰腺类型、ATG12 高表达、淋巴结转移和切缘状态是 DA 患者生存的阴性预后因素。根治性切除是适合患者的最佳治疗选择。
To evaluate the clinical risk factors that influence the overall survival in patients with duodenal adenocarcinoma (DA) after tumor resection. This study retrospectively analyzed 188 patients who underwent tumor resection for DA between January 2005 and June 2020 at Xiangyang Central Hospital. The median survival of the patients who underwent resectional operation was 54 months, longer than of those who underwent palliative surgery (20.8 months) (2,916.17; 95% CI, 916.3−9,280.5; p < 0.001). Survival of non-ampullary duodenal carcinoma patients (50.3 months; 95% CI, 39.7−61.8) was similar to that of ampullary duodenal carcinoma patients (59.3 months; 95% CI, 38.6−66.7) but was significantly better than that of papillary adenocarcinoma patients (38.9 months; 95% CI, 29.8−54.8; p = 0.386). Those with intestinal-type ductal adenocarcinomas had a longer median overall survival than those with the gastric type (61.8 vs. 46.7 months; p < 0.01) or pancreatic type (32.2 months; p < 0.001). Clinical DA samples had significantly diverse expressions of ATG12, IRS2, and IGF2. Higher expressions of the ATG12 and IRS2 proteins were significantly correlated with worse survival. Multivariate Cox regression analysis revealed that lymph node metastasis (hazard ratio (HR), 6.44; 95% CI, 3.68−11.27; p < 0.0001), margin status (HR, 4.94; 95% CI, 2.85−8.54; p < 0.0001), and high expression of ATG12 (HR, 1.89; 95% CI, 1.17−3.06; p = 0.0099) were independent prognostic factors negatively associated with survival in patients undergoing curative resection. There was no survival difference between the groups with ampullary, non-ampullary, and papillary adenocarcinomas treated with adjuvant chemotherapy (p = 0.973). Gastric/pancreatic type, high expression of ATG12, lymph node metastases, and margin status were negative prognosticators of survival in patients with DAs than in those with tumor anatomical location. Curative resection is the best treatment option for appropriate patients.
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影响因子：
8.8
作者：
Sakae H;Kanzaki H;Nasu J;Akimoto Y;Matsueda K;Yoshioka M;Nakagawa M;Hori S;Inoue M;Inaba T;Imagawa A;Takatani M;Takenaka R;Suzuki S;Fujiwara T;Okada H
通讯作者：
Okada H
影响因子：
7.5
作者：
Reid, Michelle D.;Balci, Serdar;Adsay, Volkan
通讯作者：
Adsay, Volkan
影响因子：
3.1
作者：
Overman, Michael J.;Kopetz, Scott;Wolff, Robert A.
通讯作者：
Wolff, Robert A.
影响因子：
24.5
作者：
Wheeler, JMD;Warren, BF;Bodmer, WF
通讯作者：
Bodmer, WF
影响因子：
6.2
作者：
Overman, Michael J.;Kopetz, Scoff;Wolff, Robert A.
通讯作者：
Wolff, Robert A.