晚期肺癌炎症指数与非酒精性脂肪性肝病纤维化评分相结合作为肝细胞癌手术方式选择的有前景的标志物。
Combination of advanced lung cancer inflammation index and nonalcoholic fatty liver disease fibrosis score as a promising marker for surgical procedure selection for hepatocellular carcinoma.
作者信息
Hosoda Kiyotaka, Shimizu Akira, Kubota Koji, Notake Tsuyoshi, Kitagawa Noriyuki, Yoshizawa Takahiro, Sakai Hiroki, Hayashi Hikaru, Yasukawa Koya, Soejima Yuji
机构信息
Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery Shinshu University School of Medicine Matsumoto Japan.
出版信息
Ann Gastroenterol Surg. 2024 May 20;8(6):1096-1106. doi: 10.1002/ags3.12815. eCollection 2024 Nov.
AIM
Methods of predicting severe postoperative complications after anatomical resection for hepatocellular carcinoma are yet to be established. We aimed to clarify the relationship between inflammation-based prognostic scores and liver fibrosis markers and the incidence of postoperative complications after anatomical resection for hepatocellular carcinoma as well as the usefulness of these markers in surgical procedure selection.
METHODS
We included 374 patients with hepatocellular carcinoma who had undergone initial hepatectomy between January 2007 and December 2021. The association between inflammation-based prognostic scores or liver fibrosis markers and postoperative complications was evaluated, and severe postoperative complication rates in the high-risk group defined by these markers were compared in terms of surgical procedure.
RESULTS
The advanced lung cancer inflammation index and nonalcoholic fatty liver disease fibrosis score correlated significantly with severe postoperative complications after anatomical resection, with areas under the curve of 0.67 and 0.61, respectively. The combined advanced lung cancer inflammation index and nonalcoholic fatty liver disease fibrosis score resulted in a larger area under the curve (0.69). Furthermore, in the high-risk group determined by the combined score, the anatomical resection group had a significantly higher incidence of severe complications than the partial resection group ( 0.01). There were no significant differences in prognosis among the surgical procedures in the high-risk group.
CONCLUSION
The combined advanced lung cancer inflammation index and nonalcoholic fatty liver disease fibrosis score serves as a predictive marker for severe postoperative complications after anatomical resection. This combined marker may contribute to appropriate surgical procedure selection.
目的
肝细胞癌解剖性切除术后严重并发症的预测方法尚未确立。我们旨在阐明基于炎症的预后评分与肝纤维化标志物之间的关系，以及肝细胞癌解剖性切除术后并发症的发生率，以及这些标志物在手术方式选择中的实用性。
方法
我们纳入了2007年1月至2021年12月期间接受初次肝切除术的374例肝细胞癌患者。评估基于炎症的预后评分或肝纤维化标志物与术后并发症之间的关联，并根据手术方式比较这些标志物定义的高危组中严重术后并发症的发生率。
结果
晚期肺癌炎症指数和非酒精性脂肪性肝病纤维化评分与解剖性切除术后严重并发症显著相关，曲线下面积分别为0.67和0.61。晚期肺癌炎症指数和非酒精性脂肪性肝病纤维化评分联合使用时曲线下面积更大（0.69）。此外，在联合评分确定的高危组中，解剖性切除组严重并发症的发生率显著高于部分切除组（<0.01）。高危组中不同手术方式的预后无显著差异。
结论
晚期肺癌炎症指数和非酒精性脂肪性肝病纤维化评分联合使用可作为解剖性切除术后严重术后并发症的预测标志物。这种联合标志物可能有助于选择合适的手术方式。
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