术前高FIB-4指数和NFS评分可预测胰十二指肠切除术后并发肝转移的发生率降低

IF 1.6 4区 医学 Q4 ONCOLOGY Anticancer research Pub Date : 2025-01-01 DOI:10.21873/anticanres.17413
Makoto Kawamoto, Yoshihiro Miyasaka, Hiroki Kaida, Masato Watanabe
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引用次数: 0

摘要

背景/目的:肝转移(LM)在胰腺癌中占主导地位,与低5年生存率相关。关于LM中存在脂肪肝和肝纤维化的报道是相互矛盾的。虽然肝活检是纤维化的标准诊断方法,但人们已经探索了其他侵入性较小的评分模型。本研究探讨胰头癌行胰十二指肠切除术(PD)患者术前肝脏状况与异时性LM之间的关系。患者和方法:我们对2008年至2023年间在一家大学医院接受手术的胰头癌患者进行了回顾性研究。主要的焦点是术前肝脏状况对LM复发的影响。我们比较了LM复发组和肝外复发组的临床变量。采用纤维化-4 (FIB-4)指数、nafld -纤维化评分(NFS)、天冬氨酸转氨酶(AST)与血小板(PLT)比值指数(APRI)和AST与丙氨酸转氨酶(ALT)比值评估肝脏状况。结果:对50例胰头癌行肉眼手术治疗的患者进行分析。我们分别观察到15例(30%)LM和19例(38%)肝外复发。肝外复发组包括2例病毒性肝炎和1例酒精性慢性胰腺炎。术前因素和CT平扫显示,肝外复发组血小板水平和肝脾比均显著降低。肝外复发组FIB-4指数和NFS明显高于LM复发组。结论:术前高FIB-4指数和NFS评分可能是胰头癌PD后异时性LM减少的潜在预测因素。
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Preoperative High FIB-4 Index and NFS Scores Predict a Reduced Incidence of Metachronous Liver Metastasis Following Pancreaticoduodenectomy.

Background/aim: Liver metastasis (LM), pre-dominant in pancreatic cancer, is associated with a dismal 5-year survival rate. Reports on the presence of fatty liver and liver fibrosis in LM are conflicting. Although liver biopsy is the standard diagnostic method for fibrosis, alternative, less invasive scoring models have been explored. This study examined the relationship between preoperative liver conditions and metachronous LM in patients undergoing pancreaticoduodenectomy (PD) for pancreatic head cancer.

Patients and methods: We conducted a retrospective study on patients with pancreatic head cancer who underwent surgery at a single University Hospital between 2008 and 2023. The primary focus was the effect of preoperative liver conditions on LM recurrence. We compared clinical variables between groups with LM recurrence and those with extrahepatic recurrence. Liver conditions were evaluated using the Fibrosis-4 (FIB-4) index, NAFLD-fibrosis score (NFS), aspartate aminotransferase (AST) to platelet (PLT) ratio index (APRI), and AST to alanine aminotransferase (ALT) ratio.

Results: Fifty patients who underwent macroscopic curative surgery for pancreatic head cancer were analyzed. We observed LM and extrahepatic recurrences in 15 (30%) and 19 patients (38%), respectively. The extrahepatic recurrence group included two patients with viral hepatitis and one with alcoholic chronic pancreatitis. Preoperative factors and plain CT scans revealed significantly lower platelet levels and liver-to-spleen ratios, respectively, in the extrahepatic recurrence group. The FIB-4 index and NFS were significantly higher in the extrahepatic recurrence group than in the LM recurrence group.

Conclusion: High preoperative FIB-4 Index and NFS scores could be potential predictors for reduced metachronous LM following PD for pancreatic head cancer.

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来源期刊
Anticancer research
Anticancer research 医学-肿瘤学
CiteScore
3.70
自引率
10.00%
发文量
566
审稿时长
2 months
期刊介绍: ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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