| 摘要: |
| 摘 要 目的 探讨超声引导下微波消融治疗胰腺癌肝转移的疗效，并建立列线图模型选择消融受益人群。方法 选取我院接受超声引导下微波消融治疗的胰腺癌肝转移患者41例，对肝脏转移病灶均行完全性消融。采用多因素COX回归分析胰腺癌肝转移患者预后不良独立影响因子，并建立其联合应用预测患者术后半年和1年生存率的列线图模型；绘制校准曲线和决策曲线评估该模型的有效性和临床收益情况；绘制生存曲线曲线，根据最大约登指数将纳入患者分为高危组和低危组，比较两组生存情况的差异。结果 41例患者中位生存时间为12个月，其中低危组为15个月，高危组为7个月。COX回归分析显示，CA125和综合大小（数量与最大尺寸的乘积）均为胰腺癌肝转移患者预后不良的独立危险因素（P=0.012、0.021）。列线图模型的一致性指数为0.761。列线图分数的约登指数为33，高危组与低危组的风险比为9.03，具有显著统计学差异（P=0.046）。结论 低危组胰腺癌肝转移的患者接受微波消融治疗的生存时间明显延长，可以获得明显临床受益 |
| 关键词: 胰腺癌 肝转移 微波消融 |
| DOI： |
| 投稿时间：2024-01-15修订日期：2024-03-11 |
| 基金项目: |
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| Clinical value of ultrasound-guided microwave ablation in the treatment of liver metastases of pancreatic cancer |
| MA Jun,Chai Mengwei,Ding Wenzhen,Zheng Lin,YU Jie,Liang Ping |
| (Fifth Medical Center of Chinese PLA General Hospital) |
| Abstract: |
| ABSTRACT Objective To study the therapeutic effect of ultrasound-guided microwave ablation on liver metastasis of pancreatic cancer，and establish a combined model to select the beneficiaries.Methods 41 patients with liver metastasis of pancreatic cancer who received microwave ablation in PLA General Hospital were collected.The primary lesions of the patients were moderately-poorly differentiated pancreatic cancer，and the metastatic lesions of the liver were ablated completely. COX regression analysis of independent influencing factors to establish a nomogram model，and draw calibration curves and decision curves to evaluate the performance of the model. The high-risk group and low-risk group were divided using the Jordan index as the threshold，and the difference of survival between the two groups was compared.Results The median survival time of 41 patients was 12 months，with 15 months in low-risk group and 7 months in high-risk group.COX analysis showed that CA125(P=0.012） and Comprehensive size（the product of total size and maximum size）（P=0.021） were independent risk factors for poor prognosis.The consistency index of the line chart model is 0.761.The Jordan index of the model score was 33，and the risk ratio between the high-risk group and the low-risk group was 9.03，with a significant difference（P=0.046）.Conclusion Patients with pancreatic cancer liver metastasis in the low-risk group had significantly longer survival time after microwave ablation therapy, and significant clinical benefits could be obtained. |
| Key words: Pancreatic cancer, Liver metastasis, Microwave ablation |
