Correlation Analysis Of Coagulation Index And Survival Prognosis In Untreated Pancreatic Cancer

Objective: Pancreatic cancer is a malignant tumor of digestive system,its high mortality is a major clinical problem.At present,there have been many reports on the prognostic factors of pancreatic cancer patients,and coagulation function is one of them.Previous studies have shown that the poor prognosis of pancreatic cancer patients is closely related to their hypercoagulant state.However,the subjects of these studies all included patients undergoing anticancer therapy,and the influence of therapeutic factors on coagulation function and prognosis of patients with pancreatic cancer cannot be excluded.Therefore,the purpose of this study is to explore the correlation between the survival time and coagulation indexes of untreated patients with stage I to IV pancreatic cancer,and to analyze the relationship between coagulation indexes and survival time.Methods: Patients with pancreatic cancer who were admitted to the Affiliated Hospital of Southwest Medical University between August 1,2013 and November 30,2018 were retrospectively enrolled.None of the patients received surgical treatment,radiotherapy,chemotherapy,or targeted therapy.General data,blood routine,blood coagulation indexes,imaging and pathological data of the patients were collected,and their survival time(OS)was followed up.To explore the correlation between overall survival time(OS)of patients with stage I～IV pancreatic cancer and age,sex,tumor TNM stage,carbohydrate antigen 199(CA199),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FBG),international standardization ratio(INR),platelet count(PLT),mean platelet volume(MPV),thrombocytocrit(PCT),platelet distribution width(PDW)and thrombin time(TT).The time-dependent ROC curve determines the optimal truncation value of all continuity variables.Patients were grouped for analysis.After the data were input into Epi Data,the data were analyzed using SPSS 20.0 statistical software.The median survival time was described by quartile interval M(Q1,Q3),the log-rank test was used for statistical inference,and the K-M survival curves were drawn for the significant factors in univariate analysis.Multivariate analysis was carried out using Cox risk model.All the above analyses used α=0.05 as the test level.P < 0.05 indicated a statistically significant difference.Results: A total of 253 patients with pancreatic cancer were included,the youngest was 36 years old,the oldest was 104 years old,the patients ≥65 years old accounted for 62.1%,and the patients < 65 years old accounted for 37.9%,and there was no statistical difference in OS between the two groups(P >0.05).In this study,the ratio of male to female included patients was 1.2:1.The study found that the median survival time of male patients was shorter,but there was no statistical difference in OS between male patients and female patients(P > 0.05).A total of 194 patients with stage IV pancreatic cancer were included in this study,accounting for 76.7% of the total number,which may be related to the insidious onset of pancreatic cancer and its progression to advanced stage as soon as most patients were found.At the last follow-up,on November 30,2018,only one stage III patient survived,and all the remaining patients died.There was a significant difference in OS among pancreatic cancer patients.The shortest patient OS was only 1 day,and the longest,excluding existing patients,was 1080 days.Most of the patients’ OS was less than 180days(88.5%).Univariate analysis showed that TNM stage,carbohydrate antigen 199(CA199)and prothrombin time(PT)were the prognostic factors of pancreatic cancer patients,while PT was the prognostic factor of stage IV pancreatic cancer patients.Multivariate analysis showed TNM stage IV(HR=1.501,95%CI = 1.115～2.020,P = 0.007)and PT≥14.5s(HR = 1.616,95%CI= 1.169～2.234,P = 0.004)was an independent risk factor for prognosis in patients with untreated pancreatic cancer.PT≥14.5s(HR = 1.614,95%CI =1.120～2.324,P =0.010)was an independent risk factor for prognosis in patients with stage IV untreated pancreatic cancer.Conclusion: 1.The OS of most patients are only a few months,and The OS of different patients may vary greatly.2.TNM stage IV is an independent risk factor for prognosis of untreated pancreatic cancer.PT is associated with prognosis in untreated pancreatic cancer,and patients with PT≤14.5s tend to have longer OS.