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目的探讨早期死亡风险评分(early mortality risk score,EMRS)对胰腺癌患者术后预后的预测价值,寻找胰腺癌术后预后不良的早期预测方法。方法收集就诊并接受根治性手术治疗的370例胰腺癌患者的临床资料,记录患者的性别,年龄,体质指数(BMI),肿瘤部位、大小,合并基础疾病情况,术后生存时间,EMRS评分结果等信息。根据患者术后1年的临床结局(生存,死亡)将患者分为生存组和死亡组。单因素分析法比较组间上述指标的差异,选取单因素分析当中有差异的指标进一步进行Logistic多元回归分析,以确定胰腺癌患者术后预后不良的相关危险因素,并评价EMRS对胰腺癌患者术后预后的预测价值。结果本组370例患者,根据随访1年时的临床结局分为生存组(252例)和死亡组(118例),两组患者平均年龄、性别构成、合并基础疾病、既往吸烟史、近期体重变化、肿瘤分化程度、是否合并淋巴结转移、周围神经转移、血管转移、及术后并发症发生率比较,差异无统计学意义(P>0.05);死亡组患者肿瘤相对较大,切缘阳性率、平均EMRS评分较高,组间比较差异有统计学意义(P<0.05);且肿瘤大小,切缘阳性率、EMRS评分3项指标进行多元Logistic回归分析,结果显示,该3项指标均为胰腺癌患者术后早期预后不良的独立危险因子(OR均>1.0,P均<0.05);在EMRS=3.0时,其预测患者术后早期预后不良的敏感性和特异性分别为77.4%和82.3%。结论 EMRS与胰腺癌患者术后早期预后有关,高EMRS评分是胰腺癌患者术后早期预后不良的独立危险因子,EMRS评分>3时,其预测胰腺癌患者术后早期预后不良的敏感性和特异性均较高。
Objective To investigate the prognostic value of early mortality risk score (EMRS) in patients with pancreatic cancer and to find out the early prognosis of poor prognosis of pancreatic cancer. Methods The clinical data of 370 patients with pancreatic cancer who underwent radical surgery were collected and their gender, age, body mass index (BMI), tumor location, size, underlying diseases, postoperative survival time and EMRS score were recorded And other information. Patients were divided into survival group and death group according to the clinical outcome (survival and death) of patients after one year. Univariate analysis was used to compare the differences between the above groups of indicators. Logistic regression analysis was conducted to select the univariate analysis to determine the risk factors of postoperative poor prognosis in patients with pancreatic cancer, and to evaluate the effect of EMRS on patients with pancreatic cancer The prognostic value of prognosis. Results A total of 370 patients in this study were divided into survival group (n = 252) and death group (n = 118) according to clinical outcome at one year follow-up. The average age, gender composition, underlying diseases, previous smoking history, (P> 0.05). There was no significant difference in tumor differentiation, tumor differentiation, lymph node metastasis, peripheral nerve metastasis, blood vessel metastasis and postoperative complications between the two groups , The average EMRS score higher, the difference between the groups was statistically significant (P <0.05); and the size of the tumor, the positive margins, EMRS score three indicators of multiple logistic regression analysis showed that the three indicators were The independent risk factors for early postoperative poor prognosis of patients with pancreatic cancer (OR> 1.0, all P <0.05) were 77.4% and 82.3% at EMRS = 3.0, respectively %. Conclusions EMRS is associated with early postoperative prognosis in patients with pancreatic cancer. High EMRS score is an independent risk factor for early postoperative poor prognosis in patients with pancreatic cancer. EMRS score of> 3 indicates that the prognosis of patients with pancreatic cancer is poor. Sex is higher.