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find Author "刘卓然" 2 results
  • 中性粒细胞与淋巴细胞和血小板比值联合评分对于肝细胞癌切除术后的预后预测价值

    目的探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)联合中性粒细胞与血小板比值(neutrophil to platelet ratio,NPR)评分对于肝细胞癌切除术后的预后预测价值。方法本研究回顾性收集了2013年7月至2021年12月期间于西南医科大学附属医院肝胆胰外科住院并接受手术切除且符合本研究纳入标准的肝细胞癌患者的临床病理资料,同时采用单因素和多因素Cox比例风险回归分析影响肝细胞癌手术后总生存的危险因素并建立列线图预测模型。结果本研究共纳入了符合标准的肝细胞癌患者283例。NLR、NPR 及NLR联合NPR 评分判断肝细胞癌术后总生存率的受试者操作特征曲线下面积(95%可信区间)分别为 0.643(0.579,0.708)、0.646(0.582,0.710)及0.703(0.642,0.763)。多因素分析结果显示,乙肝病毒感染(P=0.047)、丙氨酸转氨酶>40 U/L(P=0.012)、甲胎蛋白>400 μg/L(P=0.001)、肿瘤最大直径>5 cm(P=0.011)、肿瘤数目多个(P=0.010)、NLR 联合 NPR 评分 1/2 分(P=0.001/P<0.001)为肝细胞癌术后患者总生存的危险因素,基于这 6 个因素建立的列线图预测模型预测 5 年总生存率的受试者操作特征曲线下面积(95%可信区间)为 0.749(0.675,0.823)。结论本研究结果提示,患者术前NLR联合NPR评分有作为评估肝细胞癌切除术后患者的预后预测指标的潜在价值。

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  • Association between prognostic nutritional index and prognosis of patients with malignant obstructive jaundice after interventional therapy: a historical cohort study

    ObjectiveTo research the association between the prognostic nutritional index (PNI) and the prognosis of patients with malignant obstructive jaundice (MOJ) after interventional treatment. MethodsThe clinicopathologic data of patients with MOJ who were clinically diagnosed and underwent interventional treatment in the Affiliated Hospital of Southwest Medical University, from September 2018 to June 2021, were gathered retrospectively. The X-Tile statistical software was used to determine the optimal critical value of PNI before treatment, then the patients were allocated into the high PNI group (PNI was the optimal critical value or more) and low PNI group (PNI was less than the optimal critical value). The clinicopathologic characteristics of the two groups were compared. The Kaplan-Meier method was used to draw survival curve for survival analysis, and the Cox proportional hazards regression model was used to analyze the risk factors affecting the prognosis of patients with MOJ (the prognostic index was overall survival). ResultsA total of 205 patients were included in this study. The optimal critical value of PNI was 37.5. There were 154 cases in the high PNI group and 51 cases in the low PNI group, respectively. The proportions of the patients with biliary infection, CA19-9 ≥400 kU/L, hemoglobin <120 g/L, albumin <30 g/L, total bilirubin ≥300 μmol/L, and alanine aminotransferase <300 U/L were higher in the low PNI group as compared with the high PNI group (P<0.05). The median overall survival of patients in the high PNI group and low PNI group was 7.1 months and 3.6 months, respectively. The overall survival curve of the former was better than that the latter (χ2=18.514, P<0.001). The median follow-up time of 205 patients was 6.2 months, with a median overall survival of 5.3 months. The multivariate results of Cox proportional hazards regression model analysis showed that the probability of overall survival lengthening was increased for the patients with more times of PTCD, with stent implantation, with treatment for primary tumor, without metastasis, and with preoperative PNI ≥37.5 (P<0.05). ConclusionFrom the results of this study, preoperative peripheral blood PNI has a certain association with the prognosis of patients with MOJ after interventional treatment, and it is expected to be used to predict the prognosis of patients with MOJ in the future.

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