晚期卵巢癌患者的肿瘤负荷及其放射学腹膜癌指数 (PCI) 评分的验证。

Uzma Chishti, Humaira Aziz, Imrana Masroor, Aliya Begum Aziz
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摘要

研究目的比较放射学腹膜癌指数(PCI)评分和手术PCI评分,以验证其作为预测手术结果的无创方法的有效性:描述性研究。研究地点和时间:巴基斯坦卡拉奇阿迦汗大学医院妇产科,2021年9月至2022年5月:所有连续确诊为晚期卵巢癌的患者均纳入研究。手术前,使用放射成像得出的苏加贝克腹膜癌指数评分评估卵巢癌的严重程度。该评分与手术中确定的手术 PCI 评分进行了比较。评分与残留肿瘤状态之间的相关性得到了证实:研究共包括 26 名患者。患者的平均年龄为 50.17 岁,标准差为 11.04。5名患者(19.2%)首先接受了手术,而21名患者(80.8%)在接受新辅助化疗后需要进行间歇性切除手术。放射学和手术(PCI)的类间相关值为 0.52,95% 置信区间为 0.17 至 0.75。Bland-Altman图显示了PCI评分之间的一致性,显示偏差为1.115,95%置信区间为4.61。在 PCI 评分为 10 分的患者中,90% 的手术探查结果显示残留病灶为零。PCI评分低于10分的患者并发症也较少:PCI是一种无需采取侵入性措施即可预测手术成功与否以及是否存在残余疾病的有效方法。结论:PCI 是在不采取侵入性措施的情况下预测手术成功率和是否存在残留疾病的有效手段,这对决定最佳手术时间非常有帮助:腹膜癌指数 晚期卵巢癌 癌变 预后 肿瘤负荷
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Tumour Load in Advanced Ovarian Cancer Patients and Its Validation by Radiological Peritoneal Cancer Index (PCI) Score.

Objective: To compare the radiological peritoneal cancer index (PCI) score to the surgical PCI score for validating it as a non-invasive method to predict surgical outcomes.

Study design: A descriptive study. Place and Duration of the Study: Department of Obstetrics and Gynaecology of the Aga Khan University Hospital, Karachi, Pakistan from September 2021 to May 2022.

Methodology: All successive patients diagnosed with advanced-stage ovarian cancer were enrolled in the research. Prior to surgery, the severity of ovarian cancer was evaluated using the Sugarbaker Peritoneal Cancer Index score derived from radiological imaging. The score was compared to the surgical PCI score determined during the surgery. The correlation between the scores and residual tumour status was confirmed.

Results: The study included a total of 26 patients. The mean age of patients was 50.17 years, with a standard deviation of 11.04. Five (19.2%) patients underwent surgery first, whereas 21(80.8%) needed interval debulking surgery after receiving chemotherapy in the neoadjuvant setting. The interclass correlation value among radiological and surgical (PCI) was 0.52, with a 95% confidence interval ranging from 0.17 to 0.75. The Bland-Altman plot displays the agreement amongst the PCI scores, indicating a bias of 1.115 with a 95% confidence interval of 4.61. Surgical exploration revealed zero residual disease in 90% of persons with a PCI score <10. Patients with a PCI score <10 had significantly brief operative time and reduced blood loss compared to those with a score >10. Patients with a PCI score below 10 had also fewer complications.

Conclusion: PCI is an efficient means for anticipating the success of surgery and the existence of residual disease without invasive measures. This can be very helpful in deciding the best time for surgery.

Key words: Peritoneal cancer index, Advanced ovarian cancer, Carcinomatosis, Prognosis, Tumour load.

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