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Objective:To evaluate the prognostic factors for duodenalpapilla carcinoma (DPC)treated by pancreatoduodenectomy (PD).Methods:Clinicopathological data of 68 patients with duodenalpapilla carcinoma who undergone PD and finally diagnosed by surgery and histopathology from January 2001 to June 2010 were retrospectively analyzed.The patients were followed-up until 2015.Survival analysis was conducted using the Kaplan-Meier survival and Cox proportional hazards model analysis.The difference in survival curves was evaluated with a log-rank test.Results:The patients were followed-up with a median follow-up of 57 months (ranging from 4 months to 168 months).The univariate analysis showed that increased serum levels of total bilirubin were correlated with a poor prognosis,as well as a senior grade of infiltration depth,lymph node metastases,and TNM stage (P=0.043,0.003,0.004 0.002,respectively).Only increased serum levels of total bilirubin and a senior grade of TNM stage retained their significance when adjustments were made for other known prognostic factors in Cox multivariate analysis (RR=2.031,P=0.031 and RR=2.255,P=0.029).Conclusions:Increased serum levels of total bilirubin were correlated with a poor prognosis,as well as a senior grade of infiltration depth,lymph node metastases,and TNM stage.Only increased serum levels of total bilirubin and a senior grade of TNM stage can serve as independent prognosis indexes in the evaluation of patients with DPC after PD.
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Objective To investigate the pile protein (paxillin) and carbonic anhydrases Ⅸ (CA Ⅸ)expression and its significance in duodenal papilla carcinoma patients.Methods Eighty-seven cases of duodenal papilla carcinoma were enrolled as our subject.Immunohistochemical staining was used to detect the expressions of paxillin and CAⅨ in site of tumor,adjacent tissue and duodenal papillitis tissue.Results Sixtyfive cases (74.7％ (65/87)) were showed a higher expression of paxillin in cancer site than that of adjacent tissue (41％ (16/39),P ＜ 0.05) and duodenal papillitis tissue (41.3％ (19/46),P ＜ 0.05),and the difference was statisically significant (x2 =19.869,P ＜0.05).While a higher expression of CA Ⅸ in 62 cases (71.3％) in cancer site was seen,higher than that of adjacent tissue (33.3％ (13/39),P ＜ 0.05) and duodenal papillitis tissue (30.4％ (14/46),P ＜ 0.05),and the difference was statisically significant (x2 =26.936,P ＜ 0.05).As the increase of the cancer tissue malignant degree and the surrounding tissue invasion or distant metastasis degree,paxillin and CA Ⅸ expression increased.Conclusion The paxillin and CAⅨ might served as the early indicators for diagnosis and judgment of prognosis of duodenal papilla cancer.
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Objective To study the prognostic factors of primary duodenal papilla carcinoma.Methods The clinical data of 73 patients with primary duodenal papilla carcinoma who were admitted to the Dongnan Hospital of Xiamen University from June 1995 to June 2005 were retrospectively analyzed.Ten factors including gender,age,jaundice,tumor size,course of disease,total bilirubin,tumor differentiation,lymphatic metastasis,type of surgery and degree of resection were analyzed by Log-rank test.Prognostic factors with significant difference were further analyzed by the Cox regression model.The survival curve was drawn by using the Kaplan-Meier method.Results The median survival time of the patients was 34 months.Age,jaundice,tumor size,course of disease,total bilirubin,tumor differentiation,lymphatic metastasis,type of surgery and degree of resection were correlated with the prognosis (x2 =18.315,4.562,7.989,10.660,11.138,7.995,5.423,114.464,83.383,P＜0.05),while no significant difference was found between gender and prognosis ( x2 =1.720,P ＞ 0.05 ).Multivariate analysis demonstrated that tumor differentiation,type of surgery and degree of resection were the factors influencing the prognosis of patients with duodenal papilla carcinoma (RR =2.039,2.178,5.798,P＜0.05).Conclusions Tumor differentiation,type of surgery and degree of resection are the dependent factors influencing the prognosis of patients with duodenal papilla carcinoma.The standard type of surgery and degree of resection are important for the prognosis of patients.