Clinicopathological Factors And Prognosis Of Patients With Pancreatic Ductal Adenocarcinoma After Radical Operation

Objective:Retrospective analysis of postoperative and prognostic risk factors for patients with pancreatic ductal adenocarcinoma(PDAC).To explore the risk factors for postoperative survival in patients with PDAC cancer,and in order to better guide the clinical treatment and further improve the survival rate of patients after operations.Methods:The clinical datas of 92 patients with PDAC who were treated with radical surgery in the first affiliated hospital of kunming medical university from April 2008 to October 2018 were retrospectively analyzed,including general data,preoperative serological examination,preoperative imaging data and postoperative pathological data.By gender,age,diabetes,jaundice,preoperative carbohydrate antigen 19-9(CA19-9),preoperative carbohydrate antigen 125(CA125),preoperative carcinoembryonic antigen(CEA),tumor location,tumor of the American Joint Committee on Cancer(AJCC)stage,lymph node metastasis,blood vascular invasion(BVI),perineural invasion(PNI),and degree of differentiation were analyzed.Postoperative survival and time of death were obtained by outpatient or telephone follow-up.The collected data was used to establish the research database with the 2010 version of Office Excel,and the data was analyzed with the statistical software of 19.0 SPSS.Univariate and multivariate analyses of 13 variables were performed using the Cox risk ratio model to determine the risk factors and independent risk factors affecting the prognosis of PDAC patients.Survival curve was drawn by Kaplan-Meier.Chi-square test was used to compare the counting data.P<0.05 indicated that the difference was statistically significant.Results:A total of 92 PDAC patients were enrolled in this study.There were 60 male patients(65.22%)and 32 female patients(34.78%).The male to female ratio of approximately 1.9:1,with an average age of 59.66±11.303 years.The median survival time was 12.17±18.303 months,the 1-year survival rate was 27.6%,the 2-year survival rate was 15.6%,and the 3-year survival rate was 11.4%.Among the 13 clinical pathological factors,univariate analysis showed that jaundice(P<0.001),preoperative CA19-9(P=0.013),PNI(P=0.027),and degree of differentiation(P<0.001)were the risk factors of the prognosis for PDAC patients.Multivariate analysis demonstrated that jaundice(P=0.026),preoperative CA19-9(P=0.032),and degree of differentiation(P<0.001)were the influence of independent risk factors of the prognosis for PDAC patients(P<0.05).Intergroup comparison between counting data revealed that PNI(X2=9.418,P=0.009),jaundice(X2=37.641,P<0.001)and preoperative CA19-9(X2=14.201,P=0.001)were associated with degree of tumor differentiation.Conclusions:1.In patients with PDAC,Jaundice,preoperative CA19-9,PNI and degree of differentiation were significantly correlated with the prognosis of patients.2.In patients with PDAC,Jaundice,preoperative CA19-9,and degree of differentiation were independent risk factors for prognosis.When patients with PDAC are accompanied by jaundice,high preoperative CA19-9,and poor differentiation had worse prognosis.3.The lower degree of tumor differentiation in patients with PDAC,the more likely preoperative CA19-9 elevation,jaundice and PNI.