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经皮肝穿刺引流治疗晚期胆管癌患者生存的预后因素

Prognostic factors for survival in patients with advanced cholangiocarcinoma treated with percutaneous transhepatic drainage.

作者信息

Rohan Tomas, Cechova Barbora, Matkulcik Peter, Straka Matej, Zavadil Jan, Eid Michal, Uher Michal, Dostal Marek, Andrasina Tomas

机构信息

Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno, 625 00, Czechia.

Medical Faculty, Masaryk University, Brno, 625 00, Czechia.

出版信息

Sci Rep. 2025 Jan 16;15(1):2172. doi: 10.1038/s41598-025-86443-8.

Abstract

Biliary drainage is then one of the necessary procedures to help patients suffering from icterus to reduce serum bilirubin levels and relieve symptoms. The aim of this study was identifying risk factors for survival in patients with cholangiocarcinoma (CCA) treated with percutaneous transhepatic biliary drainage (PTBD) and to develop a simple scoring system predicting survival from PTBD insertion. This single-centre retrospective study included 175 consecutive patients undergoing PTBD for extrahepatic CCA (perihilar and distal). Prognostic factors affecting survival of patients with CCA treated with PTBD were analysed. A multivariate analysis showed that mass forming tumor with mass larger than 5 cm and presence of metastasis at the time of PTBD served as a negative prognostic factor (p = 0.002), better survival was associated with lower preprocedural bilirubin and lower CRP (p = 0.003). Multivariate analysis identified two significant risk factors for 3-month mortality: mass-forming tumors and bilirubin levels exceeding 185 µmol/L. A simple scoring system was developed to predict 3-month mortality after PTBD in patients with advanced CCA, demonstrating 86.3% negative predictive value and 43.2% positive predictive value.

摘要

胆道引流是帮助黄疸患者降低血清胆红素水平和缓解症状的必要手段之一。本研究的目的是确定接受经皮经肝胆道引流(PTBD)治疗的胆管癌(CCA)患者生存的危险因素,并建立一个简单的评分系统来预测PTBD置入后的生存情况。这项单中心回顾性研究纳入了175例连续接受肝外CCA(肝门部和远端)PTBD治疗的患者。分析了影响接受PTBD治疗的CCA患者生存的预后因素。多因素分析显示,肿块型肿瘤且肿块大于5 cm以及PTBD时存在转移是不良预后因素(p = 0.002),术前胆红素水平较低和CRP较低与较好的生存相关(p = 0.003)。多因素分析确定了3个月死亡率的两个显著危险因素:肿块型肿瘤和胆红素水平超过185 μmol/L。建立了一个简单的评分系统来预测晚期CCA患者PTBD后的3个月死亡率,其阴性预测值为86.3%,阳性预测值为43.2%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb50/11742682/14baf56f826f/41598_2025_86443_Fig1_HTML.jpg

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