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Objective:To explore prognostic factors of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) patients.Methods:Clinical data on 227 patients with IPMN-B between 2004 and 2015 were retrospectively collected from the surveillance, epidemiology, and end results (SEER) database. There were 126 male and 101 female patients with the age at diagnosis of 69(58, 77) years old. IPMN-B patients were divided into two groups based on whether surgical treatment was performed. There were 129 patients in the surgery group and 98 patients in the non-surgery group. The survival analyses were assessed by Kaplan-Meier analyses and log-rank test was used to compared survival rate. The univariate and multivariate Cox analyses were applied to find independent prognostic factors of the survival in IPMN-B patients.Results:The tumor size of 227 IPMN-B patients from the SEER database was 25(18.5, 45.0) mm. The differences of tumor size, grade of defferentiation, American Joint Committee on Cancer (AJCC) stage, T stage, M stage chemotherapy were statistically significant respectively in surgery group and non-surgery group (all P<0.05). The median overall survival time (OS) of patients with IPMN-B was 14 months and the overall 1-year survival was 53.4%. The median overall survival time of IPMN-B patients in surgery group was 27 months, which was better than 5 months of patients in non-surgery group, and the difference was statistically significant ( P<0.001). Univariate Cox analysis found AJCC stage, T stage, N stage, M stage and surgery were prognostic factors in patients with IPMN-B. Multivariate Cox analysis showed that M1 stage ( HR=2.125, 95% CI: 1.472-3.066, P<0.001) was independent risk factor of prognosis while surgery ( HR=2.983, 95% CI: 2.106-4.224, P<0.001) was independent protective factor of prognosis. Conclusion:The AJCC staging system is an important predictor for evaluating the prognosis of IPMN-B patients. Surgery could significantly improve the prognosis of patients with IPMN-B.
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Objective:To investiagte the ability of albumin-indocyanine green (ALICE) score, albumin-bilirubin (ALBI) score and Child-Pugh score in predicting postoperative liver failure (PHLF) in patients with hepatocellular carcinoma, and to determine the clinical value of ALICE score.Methods:The clinical data of 397 patients with hepatocellular carcinoma who underwent hepatectomy in the Department of Hepatobiliary and Pancreatic Surgery, Jinhua Hospital Affiliated to Zhejiang University from June 2015 to June 2021 were retrospectively analyzed, including 350 males and 47 females, aged (58.9±11.2) years. Univariate and multivariate logistic regression were used to analyze the risk factors of PHLF. The predictive ability of ALICE score for PHLF was evaluated by receiver operating characteristic (ROC) curve, and compared with ALBI score and Child-Pugh score.Results:There were 74 patients with PHLF and 323 patients without PHLF. Multivariate logistic regression analysis showed that Child-Pugh score ( OR=1.630, 95% CI: 1.251-2.486, P=0.034), ALBI score ( OR=1.863, 95% CI: 1.028-3.119, P=0.049) and ALICE score ( OR=1.759, 95% CI: 1.216-3.078, P=0.038) were independent risk factors for PHLF in patients with hepatocellular carcinoma, and the risk of PHLF increased with the increase of grade. The area under the ROC curve of ALICE score predicting PHLF in patients with hepatocellular carcinoma was 0.613 (95% CI: 0.564-0.662), the area under the ALBI score was 0.612 (95% CI: 0.563-0.661), and the area under the Child-Pugh score was 0.555 (95% CI: 0.505-0.605). The ALICE score was better than the Child-Pugh score, and the difference was statistically significant ( z=2.04, P=0.041). In small liver resection patients, ALICE score was better than Child-Pugh score ( z=2.61, P=0.009). There was no significant difference betwenn ALICE score and ALBI score ( z=0.06, P=0.954). Conclusion:ALICE score can predict the occurrence of PHLF in patients with hepatocellular carcinoma, especially in patients with small liver resection, its value is similar to ALBI score, but better than Child-Pugh score.
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Objective:To evaluate the prediction value of preoperative Fibrinogen(FIB) in combination with neutrophil-lymphocyte ratio(NLR)for the prognosis of operable pancreatic cancer patients.Methods:The clinical data of 124 patients who underwent radical resection for pancreatic cancer in our hospital from Jan 2010 to Dec 2018 were retrospectively analyzed.The patients were divided into three groups according the high and low NLR, FIB value which defined by the receiver operating characteristic curve (ROC). The clinicopathological data and overall median survival time were compared between the three groups.Results:Univarate analysis showed that age, tumor stage, NLR, FIB and F-NLR score were associated with the prognosis( P<0.05), while multivariate analysis showed that high F-NLR score was the independent prognostic factor. The median survival time of patients with F-NLR scores 0, 1 and 2 group was 30.6, 20.3 and 13.9 months( P<0.05). The prognosis of high F-NLR score was significantly worse than that of low F-NLR score( P<0.05). Conclusions:A high preoperative F-NLR score was a promising predictor for the prognosis of pancreatic cancer patients after radical resection.
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Objective To explore the status of mutations of k-ras gene in colorectal cancer (CRC) patients and to make theory preparation for the k-ras mutation detection in diagnosis laboratory. Methods The Genomic DNA was extracted, mutation analysis of k-ras was detected by PCR and bi-direction sequencing in the 56 specimens. Results Rate of k-ras mutation was 46.63 % (26/56) including 76.92 % (20/26) located at codon 12, and 23.08 %(6/26) located at codon 13, and no mutation was found at both codons simultaneously. G>A transition is the most common type of k-ras mutation,GGT>GAT (G12D) is the predominant mutation at codon 12 and GGOGAC (G13D) at codonl3. Chi-square analysis revealed the k-ras mutation was significantly correlated to the gender of the patients. Conclusion The k-ras mutation is mainly located at the codon 12, G>A transition is the most type of k-ras mutation in CRC. k-ras mutation seems to correlate with the gender of CRC patients.