Nutritional prognostic scores in patients with hilar cholangiocarcinoma treated by percutaneous transhepatic biliary stenting combined with 125I seed intracavitary irradiation: A retrospective observational study.
Nutritional prognostic scores in patients with hilar cholangiocarcinoma treated by percutaneous transhepatic biliary stenting combined with 125I seed intracavitary irradiation: A retrospective observational study.
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经皮经肝胆道支架治疗的肺胆管癌患者的营养预后评分与125i种子腔内辐射相结合：一项回顾性观察性研究。
DOI：
10.1097/md.0000000000011000
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发表时间：
2018-06
期刊：
影响因子：
1.6
通讯作者：
Liu H
中科院分区：
文献类型：
--
作者：
Cui P;Pang Q;Wang Y;Qian Z;Hu X;Wang W;Li Z;Zhou L;Man Z;Yang S;Jin H;Liu H
本研究旨在初步探讨基于营养的预后评分对晚期肝门部胆管癌（HCCA）患者的预后价值。我们回顾性分析了2012年11月至2017年4月在我科接受经皮经肝胆管胆道支架植入术（PTBS）联合125 I粒子腔内照射的73例HCCA患者。观察术后总胆红素（TBIL）、直接胆红素（DBIL）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、碱性磷酸酶（ALP）、白蛋白（ALB）的变化。收集术前临床资料，计算营养评分，包括控制性营养状态（CONUT）、C反应蛋白/白蛋白比值（CAR）和预后营养指数（PNI）。采用Kaplan-Meier曲线和考克斯回归模型分析总生存期（OS）。术后1个月和3个月，血清TBIL、DBIL、ALT、AST和ALP水平明显降低，ALB明显升高。中位生存期为12个月，1年生存率为53.1%。单因素分析显示，与OS相关的统计学显著性因素为CA 19 -9、TBIL、ALB、CONUT和PNI。多因素分析进一步确定CA 19 -9、CONUT和PNI为独立的预后因素。基于营养的预后评分，特别是CONUT和PNI，可用作不可切除的HCCA生存的预测因子。
We mainly aimed to preliminarily explore the prognostic values of nutrition-based prognostic scores in patients with advanced hilar cholangiocarcinoma (HCCA). We retrospectively analyzed 73 cases of HCCA, who underwent percutaneous transhepatic biliary stenting (PTBS) combined with 125I seed intracavitary irradiation from November 2012 to April 2017 in our department. The postoperative changes of total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and albumin (ALB) were observed. The preoperative clinical data were collected to calculate the nutrition-based scores, including controlling nutritional status (CONUT), C-reactive protein/albumin ratio (CAR), and prognostic nutritional index (PNI). Kaplan–Meier curve and Cox regression model were used for overall survival (OS) analyses. The serum levels of TBIL, DBIL, ALT, AST, and ALP significantly reduced, and ALB significantly increased at 1 month and 3 months postoperatively. The median survival time of the cohort was 12 months and the 1-year survival rate was 53.1%. Univariate analysis revealed that the statistically significant factors related to OS were CA19-9, TBIL, ALB, CONUT, and PNI. Multivariate analysis further identified CA19-9, CONUT, and PNI as independent prognostic factors. Nutrition-based prognostic scores, CONUT and PNI in particular, can be used as predictors of survival in unresectable HCCA.