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通过手术前后血小板的动态变化预测可手术胃癌患者的预后:一项回顾性队列研究

Predicting the prognosis of operable gastric cancer patients by dynamic changes in platelets before and after surgery: a retrospective cohort study.

作者信息

Li Jiante, Yang Xinxin, Wang Xiang, Jiang Yiwei, Wang Zhonglin, Shen Xian, Li Zhaoshen

机构信息

Department of Anorectal Surgery, The 2nd Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.

Department of Gastrointestinal Surgery, The 2nd Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.

出版信息

J Cancer Res Clin Oncol. 2023 Nov;149(17):15479-15487. doi: 10.1007/s00432-023-05334-5. Epub 2023 Aug 29.

Abstract

PURPOSE

Since the relationship between postoperative platelet count and prognosis is still unclear, we designed a standardized index of platelet count to predict the prognosis of gastric cancer (GC).

METHODS

We designed a development validation cohort for the pre/post platelet ratio. We determined the ability of PPR to predict mortality in gastric cancer patients and validated them by a separate cohort. Survival was assessed by Kaplan-Meier analysis and associations explored by multivariate and multivariate analyses. The usefulness of the prediction was estimated by measuring the time-dependent ROC. Decision-curve analysis was used to validate the net clinical benefit.

RESULTS

The sample distribution was similar in the two cohorts, and the 1-, 3-, and 5-year OS evaluation of the postoperative/preoperative platelet ratio was the largest for AUC in the two cohorts. Meanwhile, PPR has a good predictive value and a net clinical benefit.

CONCLUSIONS

PPR has been identified and validated to be independently concerned about OS of patients with GC and was a reliable and economic indicator to evaluate the prognosis.

摘要

目的

由于术后血小板计数与预后之间的关系仍不明确,我们设计了一种标准化的血小板计数指标来预测胃癌(GC)的预后。

方法

我们为术前/术后血小板比率设计了一个开发验证队列。我们确定了PPR预测胃癌患者死亡率的能力,并通过一个独立队列对其进行验证。通过Kaplan-Meier分析评估生存率,并通过多变量和多变量分析探索相关性。通过测量时间依赖性ROC来估计预测的有用性。决策曲线分析用于验证净临床获益。

结果

两个队列中的样本分布相似,术后/术前血小板比率的1年、3年和5年总生存期评估在两个队列中AUC最大。同时,PPR具有良好的预测价值和净临床获益。

结论

PPR已被确定并验证为独立关注GC患者的总生存期,是评估预后的可靠且经济的指标。

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