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开发和验证新型评分系统,用于预测结直肠肝转移切除术后疾病复发。

Development and validation of novel scoring system for the prediction of disease recurrence following resection of colorectal liver metastasis.

机构信息

Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.

Division of Colorectal Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.

出版信息

Asian J Surg. 2020 Feb;43(2):438-446. doi: 10.1016/j.asjsur.2019.06.001. Epub 2019 Aug 19.

Abstract

BACKGROUND

The aim of this study was to identify predictive factors for the recurrence of colorectal cancer liver metastasis (CRLM) and then to develop a corresponding novel scoring system that should improve the sensitivity of predicting recurrence in patients with CRLM.

METHODS

A total of 295 consecutive CRLM patients were enrolled in our institution between January 2002 and December 2015. Multivariate analyses were performed to identify the variables associated with disease recurrence and established the novel scoring system based on it.

RESULTS

The scoring system considered seven variables: synchronosity, CA19-9 level, number of liver metastasis, largest size of liver metastasis, resection margin of hepatic lesion, neutrophil-to-lymphocyte ratio and prognostic nutritional index. The area under the curve of ROC was 0.824 (95% confidence interval 0.767-0.882); the sensitivity of our scoring system was 87.9%, specificity was 66.7%, positive predictive value was 20.6%, and negative predictive value was 20.9%.

CONCLUSION

For patients with CRLM undergoing curative hepatic resection, our novel scoring system would improve the sensitivity for prediction of disease recurrence in Case of CRLM patients.

摘要

背景

本研究旨在确定结直肠癌肝转移(CRLM)复发的预测因素,然后开发相应的新型评分系统,以提高对 CRLM 患者复发的预测敏感性。

方法

本研究纳入了 2002 年 1 月至 2015 年 12 月期间在我院接受治疗的 295 例 CRLM 患者。采用多变量分析来确定与疾病复发相关的变量,并在此基础上建立新型评分系统。

结果

该评分系统考虑了 7 个变量:同步性、CA19-9 水平、肝转移灶数量、最大肝转移灶大小、肝病变切除边缘、中性粒细胞与淋巴细胞比值和预后营养指数。ROC 曲线下面积为 0.824(95%置信区间 0.767-0.882);该评分系统的敏感性为 87.9%,特异性为 66.7%,阳性预测值为 20.6%,阴性预测值为 20.9%。

结论

对于接受根治性肝切除术的 CRLM 患者,我们的新型评分系统可提高对 CRLM 患者疾病复发的预测敏感性。

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