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find Author "丛赟" 3 results
  • 光动力疗法联合胆道支架与125I粒子支架在不可切除肝外胆管癌的疗效对比研究

    目的对比分析光动力疗法(photodynamic therapy,PDT)联合胆道支架和125I粒子支架治疗晚期肝外胆管癌患者的疗效。 方法回顾性收集2015年1月1日至2023年12月31日期间新疆医科大学第一附属医院收治的32例肝门部胆管癌(Bisnmuth Ⅰ ~Ⅱ型)或胆总管中下段癌患者的临床资料,根据治疗方法的不同分为PDT联合胆道支架组(简称PDT+支架组,9例)和125I粒子支架组(23例),比较2组患者在手术时间、总住院时间、术后并发症发生率、支架通畅时间和生存时间方面的差异。 结果PDT+支架组的手术时间为(83.00±38.40)min,125I粒子支架组的手术时间为(73.70±30.12)min,PDT+支架组的手术时间略长于125I粒子支架组,但差异无统计学意义(P=0.471); PDT+支架组的总住院时间长于125I粒子支架组 [15.0(11.5,17.5)d 比 9.0(7.0,12.0)d],2组间的差异有统计学意义(P=0.038)。PDT+支架组术后出现并发症2例(22.2%),125I粒子支架组术后出现并发症3例(13.0%),2组间的差异无统计学意义(P=0.604)。PDT+支架组的中位支架通畅时间和中位生存时间均长于125I粒子支架组 [8.0(4.5,10.0)个月比 7.0(4.0,11.0)个月;10.0(7.3,13.5)个月比 8.0(5.0,12.0)个月],但2组间的差异均无统计学意义(P>0.05)。结论单次PDT联合胆道支架治疗晚期胆管癌在延长支架通畅时间和生存时间方面具有一定优势,但其有效性和安全性与125I粒子支架治疗差异并不显著。

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  • Analysis of risk factors and development of nomogram predictive model for early recurrence after curative liver resection for hepatocellular carcinoma

    ObjectiveTo analyze the risk factors and develop a nomagram predictive model for early recurrence after curative resection for hepatocellular carcinoma (HCC). MethodsThe clinicopathologic data of the patients with HCC who underwent radical hepatectomy at the First Affiliated Hospital of Xinjiang Medical University from August 2017 to August 2021 were retrospectively collected. The univariate and multivariate logistic regression analysis were used to screen for the risk factors of early recurrence for HCC after radical hepatectomy, and a nomogram predictive model was established based on the risk factors. The receiver operating characteristic (ROC) curve and calibration curve were used to validate the predictive performance of the model, and the decision curve analysis (DCA) curve was used to evaluate its clinical practicality. ResultsA total of 302 patients were included based on the inclusion and exclusion criteria, and 145 (48.01%) of whom experienced early recurrence. The results of multivariate logistic regression model analysis showed that the preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), γ-glutamate transferase (GGT), alpha fetoprotein (AFP), tumor size, and microvascular invasion (MVI) were the influencing factors of early recurrence for HCC after radical resection (P<0.05). The nomogram was established based on the risk factors. The area under the ROC curve of the nomogram was 0.858 [95%CI (0.816, 0.899)], and the Brier index of the calibration curve of the nomogram was 0.152. The predicted result of the nomogram was relatively close to the true result (Hosmer-Lemeshow test, P=0.913). The DCA result showed that the clinical net benefit of intervention based on the predicted probability of the model was higher than that of non-intervening in all HCC patients and intervening in all HCC patients when the threshold probability was in the range of 0.1 to 0.8. ConclusionsThe results of this study suggest that for the patients with the risk factors such as preoperative NLR greater than 2.13, PLR greater than 108.15, GGT greater than 46.0 U/L, AFP higher than 18.96 μg/L, tumor size greater than 4.9 cm, and presence of preoperative MVI need to closely pay attention to the postoperative early recurrence. The nomogram predictive model constructed based on these risk factors in this study has a good discrimination and accuracy, and it could obtain clinical net benefit when the threshold probability is 0.1 to 0.8.

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  • Research advances in early postoperative recurrence of hepatocellular carcinoma with microvascular invasion

    Objective To explore the impact of microvascular invasion (MVI) on the survival prognosis of patients after radical hepatectomy for hepatocellular carcinoma, to analyze its related risk factors, and to provide reference and support for the treatment of early postoperative recurrence. MethodsBy searching domestic and international medical literature databases, we screened studies related to MVI in hepatocellular carcinoma, focusing on the definition, grading, risk factors, preoperative prediction methods, and postoperative treatment strategies of MVI, and summarized the results of the existing studies. ResultsMVI is widely recognized as a significant risk factor for the intrahepatic metastasis and early postoperative recurrence of hepatocellular carcinoma. This paper aims to comprehensively investigate the characteristics of MVI and its impact on the postoperative recurrence of hepatocellular carcinoma, with a specific focus on identifying the risk factors associated with MVI. The study encompasses cutting-edge fields such as imaging genomics and genomics, with the objective of providing a scientific foundation for preoperative evaluation. Additionally, the paper examines postoperative treatment strategies for MVI, including comprehensive options such as local therapy, systemic therapy, and antiviral therapy, in order to establish a multidimensional intervention pathway for patients with hepatocellular carcinoma. The ultimate goal is to enhance prognosis and reduce recurrence rates. In the future, further refinement of MVI-related risk factors and optimization of preoperative prediction models, along with the development of personalized postoperative treatment plans, will be crucial areas of focus for hepatocellular carcinoma research and clinical practice. ConclusionsThe study of MVI and its targeted treatment strategies are important for reducing the postoperative recurrence rate of hepatocellular carcinoma and improving patient survival. The preoperative prediction model and postoperative treatment plan should be optimized in the future to provide more effective treatment reference for patients.

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