Li Weizheng, Wu Changliang, Qin Mengbin, Cai Fuqing, Huang Jiean
The Second Affiliated Hospital of Guangxi Medical University, PR China.
Medicine (Baltimore). 2020 Feb;99(9):e19282. doi: 10.1097/MD.0000000000019282.
The global incidence of pyogenic liver abscess (PLA) is increasing, but related reports of malignant tumor-related PLA are infrequent. Potential malignant tumors of PLA have been reported, but there is no relevant predictive model for this subsection of patients.To explore the risk factors of malignant tumor-related PLA.A retrospective analysis about a total of 881 patients who had been diagnosed with PLA from January 2005 to May 2018 was performed. The incidence of malignant tumor-related PLA in the study was 9.99% (88/881) out of all PLA cases. And that of potential malignant tumors with PLA was 4.65% (41/881). There were 62 patients with malignant tumor-related PLA in the observation group, while 146 cases without malignant tumor-related PLA were considered as control group. The data from 52 cases of malignant tumor and nonmalignant tumor-related PLA was verified.The malignant tumor type was mainly hepatobiliary malignant tumor, which occupies 72.3% (45/62) in all malignant tumor related PLA cases used to the model. Compared with nonmalignant tumor group, the rate of ineffective and mortality was higher in the malignant tumor group [19.4%(12/62) vs 7.5%(11/148), P = .01]. Multivariate analysis suggested that hepatobiliary interventional therapy or surgery, hepatitis B virus infection, multiple abscesses, portal embolism, and bile duct dilatation were independent risk factors for potential malignant tumors within the patients who combined with PLA.PLA could be considered as an early warning sign of potential malignant tumors. Malignant tumor-related PLA had a poor prognosis. Patients with PLA who have more than one independent risk factor or logit(P) > -1.694 may be considered as the high risk group for potential hepatobiliary or colorectal malignant tumors.
化脓性肝脓肿（PLA）的全球发病率正在上升，但关于恶性肿瘤相关PLA的相关报道并不常见。已有PLA潜在恶性肿瘤的报道，但针对这部分患者尚无相关预测模型。为探讨恶性肿瘤相关PLA的危险因素。对2005年1月至2018年5月期间共881例诊断为PLA的患者进行回顾性分析。在所有PLA病例中，本研究中恶性肿瘤相关PLA的发生率为9.99%（88/881）。PLA合并潜在恶性肿瘤的发生率为4.65%（41/881）。观察组有62例恶性肿瘤相关PLA患者，146例无恶性肿瘤相关PLA患者作为对照组。对52例恶性肿瘤和非恶性肿瘤相关PLA的数据进行了验证。恶性肿瘤类型主要为肝胆恶性肿瘤，在用于模型的所有恶性肿瘤相关PLA病例中占72.3%（45/62）。与非恶性肿瘤组相比，恶性肿瘤组的无效和死亡率更高[19.4%（12/62）对7.5%（11/148），P = 0.01]。多因素分析表明，肝胆介入治疗或手术、乙型肝炎病毒感染、多发性脓肿、门静脉栓塞和胆管扩张是合并PLA患者潜在恶性肿瘤的独立危险因素。PLA可被视为潜在恶性肿瘤的早期预警信号。恶性肿瘤相关PLA预后较差。具有一个以上独立危险因素或logit（P）> -1.694的PLA患者可被视为潜在肝胆或结直肠恶性肿瘤的高危人群。
