Xiao-Feng Chen, Jun-Peng Lin, Hang Zhou, Bing-Zi Kang, Rahul Nayak, Lin Gao, Shui-Sen Jiang, Feng Wang
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This study aimed to establish a quantitative collagen score to describe changes in the collagen structure in the extracellular matrix and to identify patients at high risk of postoperative AL.</p><p><strong>Methods: </strong>A retrospective study of 213 patients was conducted. Clinical and pathological data were collected at baseline. Optical imaging of the \"donut\" specimen at the anastomotic gastric end and collagen feature extraction were performed. Least absolute shrinkage and selection operator (LASSO) regression models were used to select the significant collagen features, compute collagen scores, and validate the predictive efficacy of the collagen scores for ALs.</p><p><strong>Results: </strong>LASSO regression analysis revealed three collagen-related parameters in the gastric donuts: histogram mean, histogram variance, and histogram energy. Based on this analysis, we established a formula to calculate the collagen score. The results of the univariate analysis revealed significant differences in the preoperative low albumin values (P=0.002) and collagen scores between the AL and non-AL groups (P=0.001), while the results of the multivariate analysis revealed significant differences in the collagen scores between the AL and non-AL groups (P=0.002). The areas under the curve (AUCs) of the experimental and validation cohorts were 0.978 [95% confidence interval (CI): 0.931-0.996] and 0.900 (95% CI: 0.824-0.951), respectively.</p><p><strong>Conclusions: </strong>The collagen score established herein was shown to be related to AL and can be used to predict AL in patients who underwent esophagectomy.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320265/pdf/","citationCount":"0","resultStr":"{\"title\":\"The relationship between the collagen score at the anastomotic site of esophageal squamous cell carcinoma and anastomotic leakage.\",\"authors\":\"Xiao-Feng Chen, Jun-Peng Lin, Hang Zhou, Bing-Zi Kang, Rahul Nayak, Lin Gao, Shui-Sen Jiang, Feng Wang\",\"doi\":\"10.21037/jtd-24-427\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Anastomotic leakage (AL) has always been one of the most serious complications of esophagectomy with gastric conduit reconstruction. There are many strong risk factors for AL in clinical practice. Notably, the tension at the esophagogastric anastomosis and the blood supply to the gastric conduit directly affect the integrity of the anastomosis. However, there has been a lack of quantitative research on the tension and blood supply of the gastric conduit. Changes in extracellular matrix collagen reflect tension and blood supply, which affect the quality of the anastomosis. This study aimed to establish a quantitative collagen score to describe changes in the collagen structure in the extracellular matrix and to identify patients at high risk of postoperative AL.</p><p><strong>Methods: </strong>A retrospective study of 213 patients was conducted. Clinical and pathological data were collected at baseline. Optical imaging of the \\\"donut\\\" specimen at the anastomotic gastric end and collagen feature extraction were performed. 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The areas under the curve (AUCs) of the experimental and validation cohorts were 0.978 [95% confidence interval (CI): 0.931-0.996] and 0.900 (95% CI: 0.824-0.951), respectively.</p><p><strong>Conclusions: </strong>The collagen score established herein was shown to be related to AL and can be used to predict AL in patients who underwent esophagectomy.</p>\",\"PeriodicalId\":17542,\"journal\":{\"name\":\"Journal of thoracic disease\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320265/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of thoracic disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/jtd-24-427\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-24-427","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景:吻合口漏(AL)一直是食管切除胃导管重建术最严重的并发症之一。在临床实践中,造成 AL 的风险因素很多。其中,食管胃吻合口的张力和胃导管的血液供应直接影响吻合口的完整性。然而,目前还缺乏对胃导管张力和血液供应的定量研究。细胞外基质胶原蛋白的变化反映了张力和血液供应,而张力和血液供应会影响吻合的质量。本研究旨在建立胶原蛋白定量评分,以描述细胞外基质中胶原蛋白结构的变化,并识别术后AL高风险患者:方法:对 213 名患者进行了回顾性研究。方法:对 213 名患者进行了回顾性研究,收集了基线时的临床和病理数据。对吻合口胃端的 "甜甜圈 "标本进行光学成像并提取胶原蛋白特征。使用最小绝对收缩和选择算子(LASSO)回归模型选择重要的胶原蛋白特征,计算胶原蛋白评分,并验证胶原蛋白评分对ALs的预测效果:结果:LASSO 回归分析发现了胃甜甜圈中与胶原蛋白相关的三个参数:直方图平均值、直方图方差和直方图能量。在此基础上,我们建立了胶原蛋白评分的计算公式。单变量分析结果显示,术前低白蛋白值(P=0.002)和胶原蛋白评分在 AL 组和非 AL 组之间存在显著差异(P=0.001),而多变量分析结果显示,胶原蛋白评分在 AL 组和非 AL 组之间存在显著差异(P=0.002)。实验组和验证组的曲线下面积(AUC)分别为 0.978 [95% 置信区间 (CI):0.931-0.996] 和 0.900 (95% CI:0.824-0.951):本文建立的胶原蛋白评分与 AL 相关,可用于预测食管切除术患者的 AL。
The relationship between the collagen score at the anastomotic site of esophageal squamous cell carcinoma and anastomotic leakage.
Background: Anastomotic leakage (AL) has always been one of the most serious complications of esophagectomy with gastric conduit reconstruction. There are many strong risk factors for AL in clinical practice. Notably, the tension at the esophagogastric anastomosis and the blood supply to the gastric conduit directly affect the integrity of the anastomosis. However, there has been a lack of quantitative research on the tension and blood supply of the gastric conduit. Changes in extracellular matrix collagen reflect tension and blood supply, which affect the quality of the anastomosis. This study aimed to establish a quantitative collagen score to describe changes in the collagen structure in the extracellular matrix and to identify patients at high risk of postoperative AL.
Methods: A retrospective study of 213 patients was conducted. Clinical and pathological data were collected at baseline. Optical imaging of the "donut" specimen at the anastomotic gastric end and collagen feature extraction were performed. Least absolute shrinkage and selection operator (LASSO) regression models were used to select the significant collagen features, compute collagen scores, and validate the predictive efficacy of the collagen scores for ALs.
Results: LASSO regression analysis revealed three collagen-related parameters in the gastric donuts: histogram mean, histogram variance, and histogram energy. Based on this analysis, we established a formula to calculate the collagen score. The results of the univariate analysis revealed significant differences in the preoperative low albumin values (P=0.002) and collagen scores between the AL and non-AL groups (P=0.001), while the results of the multivariate analysis revealed significant differences in the collagen scores between the AL and non-AL groups (P=0.002). The areas under the curve (AUCs) of the experimental and validation cohorts were 0.978 [95% confidence interval (CI): 0.931-0.996] and 0.900 (95% CI: 0.824-0.951), respectively.
Conclusions: The collagen score established herein was shown to be related to AL and can be used to predict AL in patients who underwent esophagectomy.
期刊介绍:
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.