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目的对伴远处转移胰腺癌化疗禁忌证的预测因子进行研究。方法回顾性分析87例序贯入组伴远处转移胰腺癌患者应用5-Fu,顺铂,吉西他滨等化疗后的预后。结果全组中位生存时间为3.8月;3,6,12月的生存率分别为58%,26%和3%。单变量分析显示年龄≥65岁、腹水、总胆红素>2.5mg/dl、血清胆碱酯酶(ChE)<110IU/L、高肿瘤标志物(CA19-9)水平及行为状况评分<80为伴远处转移胰腺癌化疗禁忌症的预测因子。Cox累计风险比例模型分析显示独立化疗禁忌证的预测因子为腹水、ChE水平及年龄。基于上述独立预测因子拟合出化疗风险预测模型为相对死亡风险(RRD)=exp(腹水×1.213+血清胆碱酯酶水平(ChE)×1.065+年龄×0.651)。结论出现腹水、血清胆碱酯酶(ChE)<110IU/L及年龄≥65岁的伴远处转移胰腺癌患者接受化疗并不能延长生存改善预后。
Objective To investigate the predictors of chemotherapy-induced contraindications to distant metastases. Methods Retrospective analysis of 87 cases of sequential co-operation with distant metastasis of pancreatic cancer patients with 5-Fu, cisplatin, gemcitabine and other chemotherapy prognosis. Results The overall median survival time was 3.8 months. The survival rates in 3, 6 and 12 months were 58%, 26% and 3% respectively. Univariate analysis revealed that ascites, total bilirubin> 2.5 mg / dl, ChE <110 IU / L, high tumor marker (CA19-9) and behavioral status score <80 Predictors of contraindications for chemotherapy with distant metastases in pancreatic cancer. Cox cumulative risk proportional model analysis showed that predictors of contraindications to independent chemotherapy were ascites, ChE levels, and age. Based on these independent predictors, the model of risk prediction for chemotherapy was fitted as RRD = exp (ascitic fluid × 1.213 + serum cholinesterase level (ChE) × 1.065 + age × 0.651). Conclusions Ascites, serum cholinesterase (ChE) <110 IU / L, and patients aged> 65 years with distant metastases in pancreatic cancer do not prolong survival and improve prognosis.