用于预测胆道闭锁Kasai手术后自体肝存活的预后因素。
Prognostic factors indicating survival with native liver after Kasai procedure for biliary atresia.
作者信息
Obayashi Juma, Kawaguchi Kohei, Manabe Shutaro, Nagae Hideki, Wakisaka Munechika, Koike Junki, Takagi Masayuki, Kitagawa Hiroaki
机构信息
Division of Pediatric Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan.
Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
出版信息
Pediatr Surg Int. 2017 Oct;33(10):1047-1052. doi: 10.1007/s00383-017-4135-y. Epub 2017 Aug 29.
BACKGROUND
The number of the bile ducts in the portal canal/measured surface area of the portal canal (BDP ratio) indicates prognosis in biliary atresia (BA), as does an elevated cytokeratin 7 positivity percentage (PCK7). We compared these two markers.
METHODS
We reviewed 32 BA cases undergoing Kasai operation from 1976 to 2016 with >5 portal canals in biopsy samples. Group I required liver transplantation or died within a year of operation (n = 8). Group II survived with their native liver (n = 24). We determined the BDP ratio (10/mm) and PCK7 (%), subdividing patients into three groups by their age at operation: Group A ≤60 days (n = 6, 1 Group I), 60< Group B ≤90days (n = 16, 5 Group I), Group C >90 days (n = 10, 2 Group I).
RESULTS
PCK7 (%) was 2.71 ± 1.87 in Group I and 4.25 ± 2.56 in Group II (p = 0.13). BDP ratio (10/mm) was 1.19 ± 0.424 in Group I and 1.64 ± 0.534 in Group II (p = 0.04). Both markers were higher in Group C than in Group A or B (p < 0.01).
CONCLUSION
The BDP ratio is a better prognostic indicator than PCK7 in BA.
背景
门静脉区域内胆管数量与门静脉区域测量表面积的比值（BDP 比值）可提示胆道闭锁（BA）的预后，细胞角蛋白 7 阳性率（PCK7）升高时亦是如此。我们对这两种标志物进行了比较。
方法
我们回顾了 1976 年至 2016 年间接受 Kasai 手术的 32 例 BA 病例，其活检样本中的门静脉区域超过 5 个。第一组在术后一年内需要肝移植或死亡（n = 8）。第二组依靠自身肝脏存活（n = 24）。我们测定了 BDP 比值（每平方毫米 10 个）和 PCK7（%），根据手术时的年龄将患者分为三组：A 组≤60 天（n = 6，其中 1 例属于第一组），60＜B 组≤90 天（n = 16，其中 5 例属于第一组），C 组＞90 天（n = 10，其中 2 例属于第一组）。
结果
第一组的 PCK7（%）为 2.71±1.87，第二组为 4.25±2.56（p = 0.13）。第一组的 BDP 比值（每平方毫米 10 个）为 1.19±0.424，第二组为 1.64±0.534（p = 0.04）。C 组的两种标志物均高于 A 组或 B 组（p＜0.01）。
结论
在 BA 中，BDP 比值是比 PCK7 更好的预后指标。
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