Riescher-Tuczkiewicz Alix, Grégory Jules, Bert Frederic, Zappa Magaly, Pellat Anna, Lalande Valerie, Gallois Claire, Mainardi Jean-Luc, Bachet Jean-Baptiste, Robert Jérôme, Bourrel Anne Sophie, Coriat Romain, Thabut Dominique, Hammel Pascal, Rebours Vinciane, Lorenzo Diane
Pancreatology and Digestive Oncology Department, Beaujon Hospital, AP-HP, Paris-Cité University, 100 Boulevard du Général Leclerc, Clichy 92110, France.
Inserm, INRAE, Center for Research in Epidemiology and Statistics, France and Radiology Department, Hôpital Beaujon, AP-HP.
Ther Adv Med Oncol. 2024 Jun 5;16:17588359241258440. doi: 10.1177/17588359241258440. eCollection 2024.
Bacterial peritonitis (BP) in patients with gastrointestinal (GI) cancer has been poorly described, and its prevalence is unknown.
This study aimed to evaluate in patients with both GI cancer and ascites the prevalence of BP, associated features, mechanisms, prognosis, and the diagnostic performance of neutrophil count in ascites.
A retrospective, multicenter, observational study.
All patients with GI cancer and ascites who underwent at least one paracentesis sample analyzed for bacteriology over a 1-year period were included. BP was defined by a positive ascites culture combined with clinical and/or biological signs compatible with infection. Secondary BP was defined as BP related to a direct intra-abdominal infectious source.
Five hundred fifty-seven ascites from 208 patients included were analyzed. Twenty-eight patients had at least one episode of BP and the annual prevalence rate of BP was 14%. Among the 28 patients with BP, 19 (65%) patients had proven secondary BP and 17 (59%) patients had multi-microbial BP, mainly due to . A neutrophil count greater than 110/mm in ascites had negative and positive predictive values of 96% and 39%, respectively, for the diagnosis of BP. The median survival of patients with BP was 10 days (interquartile range 6-40) after the diagnosis.
BP is not rare in patients with GI cancer and is associated with a poor short-term prognosis. When a patient with GI cancer is diagnosed with BP, a secondary cause should be sought. Further studies are needed to better define the best management of these patients.
胃肠道（GI）癌患者的细菌性腹膜炎（BP）鲜有描述，其患病率未知。
本研究旨在评估GI癌合并腹水患者中BP的患病率、相关特征、机制、预后以及腹水中性粒细胞计数的诊断性能。
一项回顾性、多中心、观察性研究。
纳入在1年期间接受至少一次腹水穿刺样本细菌学分析的所有GI癌合并腹水患者。BP定义为腹水培养阳性并伴有与感染相符的临床和/或生物学体征。继发性BP定义为与腹腔内直接感染源相关的BP。
分析了208例患者的557份腹水样本。28例患者至少发生过一次BP，BP的年患病率为14%。在28例BP患者中，19例（65%）确诊为继发性BP，17例（59%）为多微生物BP，主要原因是……腹水中性粒细胞计数大于110/mm³对BP诊断的阴性预测值和阳性预测值分别为96%和39%。BP患者诊断后的中位生存期为10天（四分位间距6 - 40天）。
BP在GI癌患者中并不罕见，且与短期预后不良相关。当GI癌患者被诊断为BP时，应寻找继发性病因。需要进一步研究以更好地确定这些患者的最佳治疗方案。
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