Analysis Of Factors Influencing Prognosis Of Primary Gallbladder Carcinoma After Operation

Objective To investigate the prognostic factors of primary gallbladder carcinoma after surgical treatment and to develop a prognostic model.Methods The data of 83patients with gallbladder carcinoma admitted to Xinjiang Uygur Autonomous Region People’s Hospital from January 2013 to January 2019 were retrospectively analyzed,and all of them were confirmed as primary gallbladder carcinoma by postoperative pathology.SPSS23.0 was used for statistical analysis of the sample data.Kaplan-Meier method was used to draw survival curve to calculate the survival rate.Univariate survival analysis was performed by Log-rank test.COX regression model was used for multivariate survival analysis.The results of multi-factor analysis were incorporated into R software to draw the survival prediction line graph model,and the prediction efficiency was verified by calibration curve and the area under ROC curve.P<0.05 was considered as significant difference.Results The mean survival period of 83 patients was(21.1±.09)months,the median survival time was 13 months,and the longest survival time was 73 months.The cumulative 1-year,2-year and 3-year survival rates were 59%,27.7%and 22.9%,respectively.Univariate analysis showed that gender(X~2=0.114P=0.736),age(X~2=0.504P=0.478),number of gallstones(X~2=4.899P=0.086),preoperative total bilirubin(X~2=0.764P=0.382)were not correlated with prognosis.(P>0.05).Preoperative Ca-199≥37U/ml(X~2=9.09 P=0.03),preoperative CEA≥5ng/ml(X~2=5.47 P=0.019),lymph node metastasis(X~2=30.289 P<0.001),non-adenocarcinoma(X~2=15.227)P<0.001),low differentiation(X~2=39.09 P<0.001),distant metastasis(X~2=44.56 P<0.001),liver invasion(X~2=41.470 P<0.001),radical surgery(X~2=7.325)P=0.007)is a risk factor affecting the prognosis of gallbladder cancer(P<0.05).Differentiation degree(HR=1.897,95%CI=1.211-2.972),TNM stage(HR=1.750,95%CI=1.084-2.826),liver invasion(HR=2.266,95%CI=1.220-4.211),surgical method(HR=2.260,95%CI=1.093-4.674)was an independent risk factor for prognosis.The calibration curve and ROC curve were drawn,and the AUC of 1,2 and 3 years was 0.922,0.932 and 0.887,respectively.Conclusion Differentiation degree,liver invasion,TNM stage and surgical method are independent risk factors for postoperative gallbladder cancer patients,and the internally verified histogram has certain predictive value.