Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkiye.
J Coll Physicians Surg Pak. 2023 Aug;33(8):879-883. doi: 10.29271/jcpsp.2023.08.879.
To determine the sensitivity of combining the model for end-stage liver disease (MELD) scoring with new inflammatory indexes in determining the priority for liver transplantation and demonstrating its potential usability in solid tumour visceral crisis.
Descriptive study. Place and Duration of the Study: Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkiye, from June 2017 to June 2022.
Patients hospitalised in the medical oncology clinic for hepatic dysfunction were included. The MELD scores of these patients were calculated, and the predictive contribution of the systemic immune-inflammatory index (SII) to prognosis and mortality was evaluated.
A total of 295 patients (158 (53.6%) men and 137 (46.4%) women) were included. When compared for primary tumour types, colorectal cancers were the most common with 55 (18.6%) cases, followed by breast cancers at 52 (17.6%), pancreatic carcinoma at 50 (16.9%), and stomach cancers at 40 (13.6%) cases. In the survival analyses of all three MELD scores (MELD-Original, MELD-Na, and MELD 3.0) between <20 groups and ≥20 groups, the median Overall Survival (OS) for MELD-Original was 1.44 vs. 0.88 months (p<0.001), for MELD- Na it was 1.64 vs. 0.85 months (p<0.001), and for MELD 3.0 it was 2.16 vs. 1.28 months (p=0.039). In the ROC analysis, the SII parameter cut-off was ≥626.28 for the estimation of mortality, SII sensitivity was 78.7%, and specificity was 100% (p=0.013).
Combined use of MELD and SII scores in patients with solid tumours with hepatic visceral crises will be practical, cost-effective, and easy to access, eliminate gender-based disparities, and contribute to clinical follow-ups with objective data.
Malignant neoplasm, MELD score, MELD-Na, MELD 3.0, SII.
确定模型终末期肝病评分（MELD）与新炎症指标联合在确定肝移植优先级方面的敏感性，并证明其在实体瘤内脏危象中的潜在可用性。
描述性研究。研究地点和时间：安卡拉 Abdurrahman Yurtaslan 肿瘤培训和研究医院，土耳其，2017 年 6 月至 2022 年 6 月。
纳入因肝功能障碍住院的肿瘤科患者。计算这些患者的 MELD 评分，并评估全身性免疫炎症指数（SII）对预后和死亡率的预测贡献。
共纳入 295 例患者（158 例男性[53.6%]和 137 例女性[46.4%]）。按原发肿瘤类型比较，结直肠癌最常见，有 55 例（18.6%），其次是乳腺癌 52 例（17.6%）、胰腺癌 50 例（16.9%）和胃癌 40 例（13.6%）。在所有三个 MELD 评分（MELD-Original、MELD-Na 和 MELD 3.0）的生存分析中，<20 分组和≥20 分组之间，MELD-Original 的中位总生存期（OS）为 1.44 个月比 0.88 个月（p<0.001），MELD-Na 为 1.64 个月比 0.85 个月（p<0.001），MELD 3.0 为 2.16 个月比 1.28 个月（p=0.039）。在 ROC 分析中，SII 参数截断值为≥626.28 用于估计死亡率，SII 敏感性为 78.7%，特异性为 100%（p=0.013）。
联合使用 MELD 和 SII 评分对患有肝内脏危象的实体瘤患者具有实用性、成本效益高、易于获取、消除基于性别的差异，并有助于提供客观数据的临床随访。
恶性肿瘤、MELD 评分、MELD-Na、MELD 3.0、SII。
