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肝脏硬度测量对肝切除患者肝脏相关手术结局的预后价值:一项荟萃分析。

Prognostic value of liver stiffness measurement for the liver-related surgical outcomes of patients under hepatic resection: A meta-analysis.

作者信息

Huang Zitong, Huang Jingjing, Zhou Tianran, Cao Hongying, Tan Bo

机构信息

School of Fundamental Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, China.

The Research Center for Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

PLoS One. 2018 Jan 11;13(1):e0190512. doi: 10.1371/journal.pone.0190512. eCollection 2018.

Abstract

BACKGROUND

Previous studies have discussed the liver stiffness measurement (LSM) performance on predicting liver-related surgical outcomes for patients of hepatocellular carcinoma (HCC) under hepatic resection, yet there is much variation in reporting and consistency of findings. Therefore, we report a meta-analysis on this issue.

METHODS

We comprehensively searched PubMed, Embase, and Web of science to find the eligible cohort studies. The pooled Odds Ratios (OR) and 95% confidence intervals (CIs) were calculated to evaluate effect. The weighted mean LSM value was calculated as the optimal LSM cut-off value among studies.

RESULTS

12 prospective cohort studies and one retrospective cohort study, including a total of 1942 cases were identified. The pooled results showed that preoperative LSM is significantly associated with the occurrence of overall postoperative complications (OR 1.76, 95% CI 1.46-2.11). In addition, a weighted mean LSM value of 14.2 kPa and 11.3KPa were suggested as the optimal LSM cut-off value reference using transient elastoqraphy (TE) for predicting overall postoperative complications in Asia countries and European countries, respectively.

CONCLUSIONS

Preoperative LSM should be taken into account cautiously in the management of patients undergoing hepatectomy of HCC. Future studies could focus on setting a prognostic model integrated with LSM in predicting post-hepatectomy outcomes.

摘要

背景

既往研究已探讨肝脏硬度测量(LSM)对预测肝细胞癌(HCC)患者肝切除术后肝脏相关手术结局的性能,但研究报告和结果的一致性存在很大差异。因此,我们报告了关于此问题的一项荟萃分析。

方法

我们全面检索了PubMed、Embase和Web of science以查找符合条件的队列研究。计算合并比值比(OR)和95%置信区间(CI)以评估效应。计算加权平均LSM值作为各研究中的最佳LSM临界值。

结果

共纳入12项前瞻性队列研究和1项回顾性队列研究,总计1942例病例。汇总结果显示,术前LSM与术后总体并发症的发生显著相关(OR 1.76,95% CI 1.46 - 2.11)。此外,建议分别以14.2 kPa和11.3KPa的加权平均LSM值作为使用瞬时弹性成像(TE)预测亚洲国家和欧洲国家术后总体并发症的最佳LSM临界值参考。

结论

在HCC肝切除患者的管理中应谨慎考虑术前LSM。未来的研究可聚焦于建立一个整合LSM的预后模型以预测肝切除术后结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/5764309/0cd935f23f66/pone.0190512.g001.jpg

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