Digestive Surgery最新文献

英文中文

Effectiveness of Intraoperative Endoscopy for Localization of Early Gastric Cancer during Laparoscopic Distal Gastrectomy 腹腔镜远端胃切除术中术中内镜对早期胃癌定位的疗效

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-04-27 DOI: 10.1159/000524565

Y. Oh, Seung Geun Yang, W. Han, B. Eom, H. Yoon, Young-Woo Kim, K. Ryu

Introduction: Intraoperative localization of tumors has been considered crucial in determining adequate resection margins during laparoscopic gastrectomy for early gastric cancer (EGC). This study has evaluated the effectiveness of intraoperative endoscopy for localization of EGC during the totally laparoscopic distal gastrectomy. Methods: Patients with EGC who received totally laparoscopic distal gastrectomy from January 2018 to March 2020 were included in this study. Except the tumors located in the antrum, the patients were categorized into two groups: no localization procedure (n = 144) and intraoperative endoscopy (n = 65). To evaluate the effectiveness of the localization procedure, proximal resection margin (PRM) involvement by the tumor and approximation of optimal PRM were compared, including their postoperative outcomes. Results: There were 3 patients (2.1%) with tumor involvement of the PRM at the initial gastric resection in the no localization group. Distance from the tumor to the PRM was determined to be not significantly different between the no localization group and intraoperative endoscopy group. The PRM distribution pattern and reconstruction method were also not significantly different between the two groups. Discussion/Conclusion: Intraoperative endoscopy for localization of EGC is an effective method to avoid tumor involvement at the resection margin during the laparoscopic gastrectomy with intracorporeal gastric resection and reconstruction.

引言:早期胃癌腹腔镜胃切除术(EGC)中，术中肿瘤定位被认为是确定足够切除边缘的关键。本研究评估了术中内镜对全腹腔镜胃远端切除术中EGC定位的有效性。方法:本研究纳入2018年1月至2020年3月接受全腹腔镜胃远端切除术的EGC患者。除位于上颌窦的肿瘤外，将患者分为未定位组(144例)和术中内镜组(65例)。为了评估定位手术的有效性，我们比较了肿瘤累及近端切除边缘(PRM)和逼近最佳PRM，包括它们的术后结果。结果:未定位组有3例(2.1%)患者在初始胃切除术时肿瘤累及PRM。未定位组与术中内镜组之间肿瘤到PRM的距离无显著差异。两组间PRM分布模式和重建方法也无显著差异。讨论/结论:术中内镜定位EGC是腹腔镜胃切除术体内胃切除术重建中避免肿瘤累及切除缘的有效方法。

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引用次数: 0

High Values of Drain Fluid Epidermal Growth Factor and Transforming Growth Factor-Beta Are Associated with the Development of Pancreatic Fistula after Pancreatoduodenectomy 引流液表皮生长因子和转化生长因子- β的高值与胰十二指肠切除术后胰瘘的发生有关

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-04-25 DOI: 10.1159/000524678

G. Marchegiani, G. Perri, F. Giovinazzo, S. Zanini, G. Turri, G. Innamorati, R. Salvia, C. Bassi

Introduction: Postoperative inflammatory response may act as a major determinant of anastomotic failure after pancreaticoduodenectomy. In this pilot study, we investigated the potential role of drain fluid cytokines in predicting postoperative pancreatic fistula (POPF). Methods: Drain fluid TGF-β, IGF-1, EGF, and IL-6, together with serum amylase and drain fluid amylase, were measured on POD1 and correlated with the development of POPF. Results: The study population consisted of 66 patients. POPF and Clavien-Dindo ≥3 morbidity rates were 12.1% and 9.1%, respectively. Patients developing POPF presented significantly higher values of POD1 serum amylase level (477 vs. 54 UI/L, p < 0.001), drain fluid amylase (7,500 vs. 127 UI/L, p < 0.001), TGFβ (94 vs. 40 pg/g, p = 0.045), and EGF (17 vs. 13, p = 0.015). There were no differences in terms of IGF-1 and IL-6 values. Conclusion: Assessing the local inflammatory response after pancreatoduodenectomy could represent a promising field of research since both TGFβ and EGF seem to be associated with the occurrence of POPF.

导言:术后炎症反应可能是胰十二指肠切除术后吻合口衰竭的主要决定因素。在这项初步研究中，我们研究了引流液细胞因子在预测术后胰瘘(POPF)中的潜在作用。方法:用POD1测定引流液中TGF-β、IGF-1、EGF、IL-6及血清淀粉酶、引流液中淀粉酶的变化，并与POPF的发生进行相关性分析。结果:研究人群包括66例患者。POPF和Clavien-Dindo≥3的发病率分别为12.1%和9.1%。POPF患者的POD1血清淀粉酶水平(477 vs. 54 UI/L, p < 0.001)、引流液淀粉酶(7500 vs. 127 UI/L, p < 0.001)、TGFβ (94 vs. 40 pg/g, p = 0.045)和EGF (17 vs. 13, p = 0.015)均显著升高。在IGF-1和IL-6值方面没有差异。结论:评估胰十二指肠切除术后局部炎症反应可能是一个有前途的研究领域，因为TGFβ和EGF似乎与POPF的发生有关。

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引用次数: 0

Outcomes of Patients with Left-Sided Obstructive Colorectal Cancer: Comparison between Self-Expandable Metallic Stent and Other Treatment Methods 左侧梗阻性结直肠癌患者的预后:自膨胀金属支架与其他治疗方法的比较

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-04-22 DOI: 10.1159/000524645

A. Kondo, K. Kumamoto, H. Kobara, Teruya Nagahara, M. Wato, M. Shibatoge, Takuya Minato, Tsutomu Masaki, K. Okano

Introduction: This multi-institutional retrospective study aimed to evaluate the efficacy of preoperative self-expandable metallic stent (SEMS) placement for patients with left-sided obstructive colorectal cancer (OCRC). Methods: Overall, 520 consecutive patients who received treatment for OCRC were enrolled. Of these, the data of 253 patients who underwent primary tumour resection for left-sided OCRC were reviewed. The short- and long-term outcomes were compared between the SEMS group and other three groups: transanal decompression tube (TaDT), decompressing stoma (DS), and emergency resection (ER). Results: The SEMS group had a higher frequency of laparoscopic surgery (p < 0.001), lesser frequency of postoperative stoma (p < 0.001), and more dissected lymph nodes (p < 0.001) than the other groups. Moreover, the SEMS group had shorter postoperative hospital stays than the TaDT, DS, and ER groups (p = 0.005, p = 0.037, and p < 0.001, respectively). The Kaplan-Meier survival curves of recurrence-free survival and overall survival did not differ significantly between the SEMS group and the other three groups in patients with stage II and III diseases. Discussion/Conclusion: Elective surgery after SEMS placement may improve short-term outcomes compared to other treatment strategies, with similar long-term outcomes.

本多机构回顾性研究旨在评估左侧梗阻性结直肠癌(OCRC)患者术前放置自膨胀金属支架(SEMS)的疗效。方法:总共入组520例连续接受OCRC治疗的患者。其中，我们回顾了253例因左侧OCRC接受原发肿瘤切除的患者的资料。比较SEMS组与其他三组(经肛门减压管(TaDT)、减压造口(DS)和急诊切除(ER))的短期和长期结果。结果:SEMS组腹腔镜手术发生率高于对照组(p < 0.001)，术后造瘘发生率低于对照组(p < 0.001)，淋巴结清扫率高于对照组(p < 0.001)。此外，SEMS组术后住院时间短于TaDT、DS和ER组(p = 0.005、p = 0.037和p < 0.001)。在II期和III期疾病患者中，SEMS组与其他三组无复发生存期和总生存期的Kaplan-Meier生存曲线无显著差异。讨论/结论:与其他治疗策略相比，SEMS放置后的择期手术可以改善短期预后，并具有相似的长期预后。

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引用次数: 1

Prognostic Factors Affecting Short- and Long-Term Outcomes of Gastrectomy for Gastric Cancer in Older Patients 影响老年癌症胃切除术中短期和长期疗效的预后因素

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-04-19 DOI: 10.1159/000524609

Nobuhiro Tsuchiya, C. Kunisaki, Hiroki Kondo, Sho Sato, Kei Sato, J. Watanabe, K. Takeda, T. Kosaka, H. Akiyama, I. Endo

Introduction: The benefits of surgery in older patients with gastric cancer are controversial. This single-institution retrospective study in Japan aimed to evaluate the impact of gastrectomy in older patients with gastric cancer. Methods: A series of 234 patients aged ≥80 years with histologically confirmed gastric cancer had indications for surgical treatment at the Gastroenterological Center, Yokohama City University Medical Center, between April 2002 and December 2018. Patients who were lost to follow-up (n = 27), had tumors not eligible for surgery (n = 14), and could not achieve R0 resection (n = 7) were excluded from this retrospective study. The remaining 186 patients were included. Patient characteristics, intraoperative outcomes, postoperative complications, and long-term survival were evaluated. Results: The incidence of postoperative complications with Clavien–Dindo grade ≥ II was observed in 61 patients (32.8%). The 5-year relapse-free survival and overall survival (OS) rates were 84.2% and 63.4%, respectively. Multivariate analysis showed that geriatric nutritional risk index (<98) (odds ratio, 1.97; p = 0.047), neutrophil/lymphocyte ratio (>2.36) (odds ratio, 1.94; 95% confidence interval, 1.02–3.67; p = 0.043), and total gastrectomy (TG) (odds ratio, 1.97; p = 0.042) significantly predicted postoperative complications. Moreover, TG (hazard ratio, 1.91; p = 0.036) was an independent prognostic factor of OS. Conclusions: Poor immunonutritional status and TG led to worse short-term outcomes. Moreover, TG was an independent prognostic factor of OS in older patients with gastric cancer. It is necessary to provide effective perioperative care, including nutritional support, to clarify whether short-term outcomes would be improved.

引言：手术对老年癌症患者的益处是有争议的。这项在日本进行的单机构回顾性研究旨在评估胃切除术对老年癌症患者的影响。方法：2002年4月至2018年12月，234名年龄≥80岁的组织学确诊的癌症患者在横滨市立大学医学中心消化道中心接受了手术治疗。失访（n=27）、肿瘤不符合手术条件（n=14）和无法实现R0切除（n=7）的患者被排除在本回顾性研究之外。其余186名患者包括在内。评估患者特征、术中结果、术后并发症和长期生存率。结果：61例患者（32.8%）出现Clavien-Dindo≥II级的术后并发症，5年无复发生存率和总生存率分别为84.2%和63.4%。多因素分析显示，老年营养风险指数（2.36）（比值比，1.94；95%置信区间，1.02–3.67；p=0.043）和全胃切除术（TG）（比值率，1.97；p=0.042）可显著预测术后并发症。此外，TG（危险比1.91；p=0.036）是OS的独立预后因素。结论：不良的免疫营养状况和TG导致更差的短期结果。此外，TG是老年癌症患者OS的独立预后因素。有必要提供有效的围手术期护理，包括营养支持，以明确短期结果是否会得到改善。

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引用次数: 4

Crohn’s Disease-Related Stoma Complications and Their Impact on Postsurgical Course 克罗恩病相关的口腔并发症及其对术后进程的影响

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-03-16 DOI: 10.1159/000524036

I. Angriman, G. Buzzi, Edoardo Giorato, M. Barbierato, Francesco Cavallin, C. Ruffolo, S. Degasperi, V. Mari, O. De Simoni, Michela Campi, Francesca Zingales, G. Roveron, M. Iafrate, S. Pucciarelli, R. Bardini, M. Scarpa

Introduction: Crohn’s disease (CD) is a chronic inflammatory disease of the gastrointestinal tract. The diversion through a colostomy or an ileostomy is sometimes required for disease control. In these patients, common stoma-related complications sum up with CD-related complications and often require revisional surgery. Methods: The aim of the study was to assess stoma morbidity after surgery for CD and to identify the burden of CD-related or CD-associated complications. Thus, details of past medical history, surgery, and follow-up of 54 consecutive patients operated on for CD with any sort of stoma were retrieved from the stoma therapist prospectively maintained database. Results: In our series, 23 patients had a colostomy, and 31 patients had an ileostomy. Complications occurred after stoma creation in 38 patients (70%) at a median of 1.3 months (interquartile range 0.6–7.2). CD-related complications arose in 8 patients (including pyoderma gangrenosum in 3 patients, peristomal fistulae in 2, granulomas in 2, and peristomal abscess in 1). Patients with CD-related complications tended to have a shorter disease duration (p = 0.07) and higher occurrence of CD-related complications was associated with end-stoma (p = 0.006). In this cohort, 11 cases had to be surgically treated for peristomal fistulae or abscess, parastomal hernia, prolapse, pyoderma gangrenosum, and recurrent CD. Discussion/Conclusions: In patients with CD, stoma creation is burdened by a high rate of postoperative complication and a relevant rate is specifically related to CD. Often these patients are required to be reoperated on to redo the stoma. Moreover, end-stoma configuration and aggressive CD phenotype are associated to a higher rate of complications.

简介：克罗恩病（CD）是一种胃肠道慢性炎症性疾病。为了控制疾病，有时需要通过结肠造口术或回肠造口术进行分流。在这些患者中，常见的造口相关并发症加上CD相关并发症，通常需要进行翻修手术。方法：本研究的目的是评估CD手术后造口的发病率，并确定CD相关或CD相关并发症的负担。因此，从造口治疗师前瞻性维护的数据库中检索了54名患有任何类型造口的CD患者的既往病史、手术和随访的详细信息。结果：在我们的系列中，23名患者进行了结肠造口术，31名患者进行回肠造口术。38名患者（70%）在造瘘后出现并发症，中位时间为1.3个月（四分位间距0.6-7.2）。8名患者出现CD相关并发症（包括3名患者出现坏疽性脓皮病，2名患者出现口周瘘，2名出现肉芽肿，1名患者出现管周脓肿）。CD相关并发症患者的病程往往较短（p=0.07），且CD相关并发症的发生率较高与造口末端有关（p=0.006）。在该队列中，11例患者因造口周围瘘或脓肿、造口旁疝、脱垂、坏疽性脓皮病和复发性CD而不得不接受手术治疗。讨论/结论：CD患者，造瘘术后并发症发生率高，相关发生率与CD特别相关。这些患者通常需要再次手术来重新造瘘。此外，末端造口结构和侵袭性CD表型与较高的并发症发生率相关。

{"title":"Crohn’s Disease-Related Stoma Complications and Their Impact on Postsurgical Course","authors":"I. Angriman, G. Buzzi, Edoardo Giorato, M. Barbierato, Francesco Cavallin, C. Ruffolo, S. Degasperi, V. Mari, O. De Simoni, Michela Campi, Francesca Zingales, G. Roveron, M. Iafrate, S. Pucciarelli, R. Bardini, M. Scarpa","doi":"10.1159/000524036","DOIUrl":"https://doi.org/10.1159/000524036","url":null,"abstract":"Introduction: Crohn’s disease (CD) is a chronic inflammatory disease of the gastrointestinal tract. The diversion through a colostomy or an ileostomy is sometimes required for disease control. In these patients, common stoma-related complications sum up with CD-related complications and often require revisional surgery. Methods: The aim of the study was to assess stoma morbidity after surgery for CD and to identify the burden of CD-related or CD-associated complications. Thus, details of past medical history, surgery, and follow-up of 54 consecutive patients operated on for CD with any sort of stoma were retrieved from the stoma therapist prospectively maintained database. Results: In our series, 23 patients had a colostomy, and 31 patients had an ileostomy. Complications occurred after stoma creation in 38 patients (70%) at a median of 1.3 months (interquartile range 0.6–7.2). CD-related complications arose in 8 patients (including pyoderma gangrenosum in 3 patients, peristomal fistulae in 2, granulomas in 2, and peristomal abscess in 1). Patients with CD-related complications tended to have a shorter disease duration (p = 0.07) and higher occurrence of CD-related complications was associated with end-stoma (p = 0.006). In this cohort, 11 cases had to be surgically treated for peristomal fistulae or abscess, parastomal hernia, prolapse, pyoderma gangrenosum, and recurrent CD. Discussion/Conclusions: In patients with CD, stoma creation is burdened by a high rate of postoperative complication and a relevant rate is specifically related to CD. Often these patients are required to be reoperated on to redo the stoma. Moreover, end-stoma configuration and aggressive CD phenotype are associated to a higher rate of complications.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 1","pages":"83 - 91"},"PeriodicalIF":2.7,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49572890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

HBPD Table of Contents HBPD目录

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-03-01 DOI: 10.1159/000523745

引用次数: 0

Front & Back Matter 正面和背面事项

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-03-01 DOI: 10.1159/000524083

D. O’Toole

引用次数: 0

EDS Society News EDS社会新闻

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-03-01 DOI: 10.1159/000523744

引用次数: 0

Identification and Validation of Hub Genes Predicting Prognosis of Hepatocellular Carcinoma. 预测肝细胞癌预后的枢纽基因的鉴定和验证。

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-01-01 Epub Date: 2021-11-17 DOI: 10.1159/000520893

Ziyan Chen, Haitao Yu, Lijun Wu, Sina Zhang, Zhihui Lin, Tuo Deng, Bangjie He, Zhengping Yu, Gang Chen, Fang Wu

Introduction: The aim of this study is selecting the hub genes associated with hepatocellular carcinoma (HCC) to construct a Cox regression model for predicting prognosis in HCC patients.

Methods: Using HCC patient data from the ICGC and TCGA databases, screened for 40 core genes highly correlated with histological grade of HCC. Univariate and multivariate Cox regression analyses were performed on the genes highly associated with HCC prognosis, and the model was established. The expression of those genes was measured by immunohistochemistry in 110 HCC patients who underwent the surgery in the First Affiliated Hospital of Wenzhou Medical University. The survival of HCC patients was analyzed by the Kaplan-Meier method.

Results: Eight genes (CDC45, CENPA, MCM10, MELK, CDC20, ASF1B, FANCD2, and NCAPH) were correlated with prognosis, and the same result was observed in 110 HCC patients. Using the regression model, the HCC patients in the training set were classified as high- and low-risk groups. The overall survival of patients in the high-risk group was shorter than that in the low-risk group, and the same results were obtained in the verification set.

Conclusion: This study found that the risk model according to these 8 genes can be used as a predictor of prognosis in HCC. These genes may become alternative biomarkers and therapeutic targets and provide new therapeutic strategies for HCC.

本研究的目的是选择与肝细胞癌(HCC)相关的枢纽基因，构建预测HCC患者预后的Cox回归模型。方法:利用ICGC和TCGA数据库中的HCC患者数据，筛选与HCC组织学分级高度相关的40个核心基因。对HCC预后高度相关基因进行单因素和多因素Cox回归分析，建立模型。在温州医科大学第一附属医院行肝细胞癌手术的110例HCC患者中，用免疫组织化学方法检测了这些基因的表达。采用Kaplan-Meier法分析HCC患者的生存期。结果:8个基因(CDC45、CENPA、MCM10、MELK、CDC20、ASF1B、FANCD2、NCAPH)与预后相关，在110例HCC患者中观察到相同的结果。利用回归模型将训练集中的HCC患者分为高危组和低危组。高危组患者总生存期短于低危组，验证集中结果相同。结论:本研究发现基于这8个基因的风险模型可作为HCC预后的预测因子。这些基因可能成为替代的生物标志物和治疗靶点，并为HCC提供新的治疗策略。

{"title":"Identification and Validation of Hub Genes Predicting Prognosis of Hepatocellular Carcinoma.","authors":"Ziyan Chen, Haitao Yu, Lijun Wu, Sina Zhang, Zhihui Lin, Tuo Deng, Bangjie He, Zhengping Yu, Gang Chen, Fang Wu","doi":"10.1159/000520893","DOIUrl":"https://doi.org/10.1159/000520893","url":null,"abstract":"Introduction: The aim of this study is selecting the hub genes associated with hepatocellular carcinoma (HCC) to construct a Cox regression model for predicting prognosis in HCC patients.Methods: Using HCC patient data from the ICGC and TCGA databases, screened for 40 core genes highly correlated with histological grade of HCC. Univariate and multivariate Cox regression analyses were performed on the genes highly associated with HCC prognosis, and the model was established. The expression of those genes was measured by immunohistochemistry in 110 HCC patients who underwent the surgery in the First Affiliated Hospital of Wenzhou Medical University. The survival of HCC patients was analyzed by the Kaplan-Meier method.Results: Eight genes (CDC45, CENPA, MCM10, MELK, CDC20, ASF1B, FANCD2, and NCAPH) were correlated with prognosis, and the same result was observed in 110 HCC patients. Using the regression model, the HCC patients in the training set were classified as high- and low-risk groups. The overall survival of patients in the high-risk group was shorter than that in the low-risk group, and the same results were obtained in the verification set.Conclusion: This study found that the risk model according to these 8 genes can be used as a predictor of prognosis in HCC. These genes may become alternative biomarkers and therapeutic targets and provide new therapeutic strategies for HCC.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"39 1","pages":"24-31"},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39632486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Prognostic Impact of Inflammation-Based Scores for Extrahepatic Cholangiocarcinoma. 肝外胆管癌炎症评分对预后的影响。

IF 2.7 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery

Pub Date : 2022-01-01 Epub Date: 2022-01-20 DOI: 10.1159/000521969

Riki Asakura, Hiroaki Yanagimoto, Tetsuo Ajiki, Daisuke Tsugawa, Takuya Mizumoto, Shinichi So, Takeshi Urade, Yoshihide Nanno, Kenji Fukushima, Hidetoshi Gon, Shohei Komatsu, Kaori Kuramitsu, Tadahiro Goto, Sadaki Asari, Masahiro Kido, Hirochika Toyama, Takumi Fukumoto

Introduction: Although the relationship between systemic inflammatory responses and prognosis has been known in various cancers, it remains unclear which scores are most valuable for determining the prognosis of extrahepatic cholangiocarcinoma. We aimed to verify the usefulness of various inflammation-based scores as prognostic factors in patients with resected extrahepatic cholangiocarcinoma.

Methods: We analyzed consecutive patients undergoing surgical resection for extrahepatic cholangiocarcinoma at our institution between January 2000 and December 2019. The usefulness of the following inflammation-based scores as prognostic factor was investigated: glasgow prognostic score (GPS), modified GPS, neutrophil-to-lymphocyte ratio, platelet to lymphocyte ratio, lymphocyte-to-monocyte ratio, prognostic nutrition index, C-reactive protein to albumin ratio (CAR), controlling nutritional status (CONUT), and prognostic index.

Results: A total of 169 patients were enrolled in this study. Of the nine scores, CAR and CONUT indicated prognostic value. Furthermore, multivariate analysis for overall survival revealed that high CAR (>0.23) was an independent prognostic factor (hazard ratio: 1.816, 95% confidence interval: 1.135-2.906, p = 0.0129), along with lymph node metastasis and curability. There was no difference in tumor staging and short-term outcomes between the low CAR (≤0.23) and high CAR groups.

Conclusions: CAR was the most valuable prognostic score in patients with resected extrahepatic cholangiocarcinoma.

虽然在各种癌症中，系统性炎症反应与预后之间的关系是已知的，但目前尚不清楚哪种评分对确定肝外胆管癌的预后最有价值。我们的目的是验证各种炎症评分作为肝外胆管癌切除术患者预后因素的有效性。方法:我们分析了2000年1月至2019年12月在我院连续接受肝外胆管癌手术切除的患者。研究了以下炎症评分作为预后因素的有效性:格拉斯哥预后评分(GPS)、改良GPS、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、淋巴细胞与单核细胞比值、预后营养指数、c反应蛋白与白蛋白比值(CAR)、控制营养状态(CONUT)和预后指数。结果:本研究共纳入169例患者。在9个评分中，CAR和CONUT显示了预后价值。此外，对总生存率的多因素分析显示，高CAR(>0.23)是一个独立的预后因素(风险比:1.816,95%可信区间:1.135-2.906,p = 0.0129)，以及淋巴结转移和治愈率。低CAR组(≤0.23)和高CAR组在肿瘤分期和短期预后方面无差异。结论:CAR是肝外胆管癌切除患者最有价值的预后评分。

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引用次数: 6

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