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胰十二指肠切除术后肝外胆管癌患者基于炎症的预后评分比较。

The Comparison of Inflammation-Based Prognostic Scores in Patients With Extrahepatic Bile Duct Cancer After Pancreaticoduodenectomy.

机构信息

Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

J Surg Res. 2019 Jun;238:102-112. doi: 10.1016/j.jss.2019.01.033. Epub 2019 Feb 12.

Abstract

BACKGROUND

Inflammation-based prognostic scores are associated with tumor recurrence and survival in various cancers. The aim of this study was to identify the significance of inflammation-based prognostic scores and to detect the most useful score in patients with distal extrahepatic bile duct cancer after pancreaticoduodenectomy.

METHODS

Between 2000 and 2015, 121 patients were enrolled in this retrospective study. The relationship between clinicopathological variables including various prognostic scores and disease-free (DFS) as well as overall (OS) survival was investigated by univariate analysis. The area under the receiver operating characteristics curve was calculated to compare the predictive ability of each scoring system. Multivariate analysis was performed to identify the clinicopathological variables associated.

RESULTS

In univariate analysis, Glasgow prognostic score (GPS), mGPS, C-reactive protein/Alb ratio score, prognostic index, and preoperative monocyte count were significant risk factors for both DFS and OS. The area under the receiver operating characteristics curve of GPS is consistently larger in comparison with other four scores in both DFS as well as OS. In multivariate analysis, GPS was an independent risk factor of both tumor recurrence and poor prognosis.

CONCLUSIONS

GPS score is an independent tumor recurrence and prognostic factor in patients with distal extrahepatic bile duct cancer and is superior to the other prognostic scores.

摘要

背景

基于炎症的预后评分与多种癌症的肿瘤复发和生存有关。本研究旨在确定基于炎症的预后评分的意义,并检测胰十二指肠切除术后远端肝外胆管癌患者中最有用的评分。

方法

在 2000 年至 2015 年间,共有 121 名患者纳入本回顾性研究。通过单因素分析研究了包括各种预后评分在内的临床病理变量与无病生存(DFS)和总生存(OS)之间的关系。计算受试者工作特征曲线下的面积以比较每个评分系统的预测能力。进行多变量分析以确定与临床病理变量相关的因素。

结果

在单因素分析中,格拉斯哥预后评分(GPS)、mGPS、C 反应蛋白/白蛋白比值评分、预后指数和术前单核细胞计数是 DFS 和 OS 的显著危险因素。GPS 在 DFS 和 OS 中的曲线下面积均明显大于其他四个评分。在多变量分析中,GPS 是肿瘤复发和不良预后的独立危险因素。

结论

GPS 评分是远端肝外胆管癌患者肿瘤复发和预后的独立因素,优于其他预后评分。

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