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Prognostic factors in the surgical treatment of caudate lobe hepatocellular carcinoma

World Journal of Gastroenterology 2010年第9期16卷 1123-1128页

作者： Peng Liu,Jia-Mei Yang,Wen-Yang Niu,Tong Kan,Feng Xie,Dian-Qi Li,Ye Wang,Yan-Ming Zhou,Department of Special Treatment and Liver Transplantation,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University,Shanghai 200438,China Peng Liu,Department of Hepatobiliary Surgery,Navy General Hospital,Beijing 100037,China Department of Special Treatment and Liver Transplantation Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China.

AIM:To evaluate the short-and long-term outcomes of liver resection for caudate lobe hepatocellular carcinoma (HCC).METHODS:We retrospectively analyzed 114 consecutive patients with HCC,originating from the caudate lobe,who underwent resection between January 2001 and January 2007.Univariate and multivariate analyses were performed on several clinicopathologic variables to determine the factors affecting long-term outcome and intrahepatic recurrence.RESULTS:Overall mortality and morbidity were 0% and 18%,respectively.After a median follow-up of 31 mo (interquartile range,11-66 mo),tumor recurrence had occurred in 76 patients (66.7%).The 1-,3-,and 5-year disease-free survival rates were 65.7%,38.1%,and 18.4%,respectively.The 1-,3-,and 5-year overall survival rates were 76.1%,54.7%,and 31.8%,respectively.Univariate analysis showed that subsegmental location of the tumor (45.7% vs 16.2%,P=0.01),liver cirrhosis (12.3% vs 47.9%,P=0.03),surgical margin (18.5% vs 54.6%,P=0.04),vascular invasion (37.9% vs 23.2%,P=0.04) and extended caudate resection (42.1% vs 15.4%,P=0.04) were related to poorer long-term survival.Multivariate analysis showed that only subsegmental location of the tumor,liver cirrhosis and surgical margin were significant independent prognostic factors.CONCLUSION:Hepatectomy was an effective treatment for HCC in the caudate lobe.The subsegmental location of the tumor,liver cirrhosis and surgical margin affected long-term survival.

关键词： Hepatectomy Hepatocellular carcinoma Caudate lobe Prognostic factors

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基于个体化机器学习的原发性免疫性血小板减少症危重出血预测模型:一项全国前瞻性队列研究

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科学通报:英文版 2023年第18期68卷 2106-2114,M0004页

作者： Zhuo-Yu An ye-Jun Wu Yu Hou Heng mei Wei-Xia Nong wen-qian li Hu zhou Ru feng jian-Ping Shen Jun peng Hai zhou Yi liu Yong-Ping Song lin-Hua yang mei-Yun Fang jian-Yong li Yun-feng Cheng Peng Liu Ya-Jing Xu Zhao wang Yi Luo Zhen Cai Hui liu Jing-wen wang Juan li Xi Zhang Zi-Min Sun Xiao-Yu Zhu Xin wang Rong Fu liang Huang Shao-Yuan wang tong-Hua yang li-Ping Su liang-ming Ma xie-Qun Chen Dai-Hong liu Hong-Xia Yao jia feng Hong-Yu Zhang ming jiang Ze-Ping zhou wen-Sheng wang Xu-liang Shen yangjin Baima Yue-Ying li qian-Fei wang qiu-Sha Huang Hai-Xia Fu Xiao-Lu Zhu Yun He qian jiang Hao jiang Jin Lu Xiang-Yu Zhao Ying-Jun Chang Tao Wu Yao-Zhu Pan lin qiu Da Gao A-Rong Jin Wei li Su-Jun Gao Lei Zhang ming Hou Xiao-Jun Huang Xiao-Hui Zhang on behalf of the National Cooperative ITP Working Group Peking university People’s hospital Peking University Institute of HematologyBeijing 100044China Collaborative Innovation Center of Hematology Peking UniversityBeijing 100044China beijing Key Laboratory of Hematopoietic Stem Cell transplantation Beijing 100044China National Clinical Research Center for Hematologic Disease Beijing 100044China department of Hematology Qilu HospitalCheeloo College of MedicineShandong UniversityJinan 250014China Institute of Hematology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430074China department of Hematology First Affiliated HospitalSchool of MedicineShihezi UniversityShihezi 832002China department of Hematology Qinghai Provincial People’s HospitalXining 810007China Henan Cancer hospital Affiliated Cancer Hospital of Zhengzhou UniversityHenan Institute of HematologyZhengzhou 450008China department of Hematology Beijing HospitalBeijing 100044China department of Hematology Zhejiang Provincial Hospital of Traditional Chinese MedicineHangzhou 310006China department of Hematology Senior Department of Hematologythe Fifth Medical Center of PLA General HospitalBeijing 100044China department of Hematology the Second Hospital of Shanxi Medical UniversityTaiyuan 030001China department of Hematology Affiliated Zhongshan Hospital of Dalian UniversityDalian 116001China department of Hematology The First Affiliated Hospital with Nanjing Medical University(Jiangsu Province Hospital)Nanjing 210029China department of Hematology Zhongshan HospitalFudan UniversityShanghai 200032China department of Hematology Xiangya HospitalCentral South UniversityChangsha 410008China department of Hematology Beijing Friendship HospitalCapital Medical UniversityBeijing 100044China Institute of Hematology the First Affiliated HospitalZhejiang UniversityHangzhou 310058China department of Hematology Beijing Tongren HospitalBeijing 100005China department of Hematology The First Affiliated HospitalSun Yat-sen UniversityGuang

原发性免疫性血小板减少症(ITP)中少见但至关重要的危重出血事件,给患者的预后、生活质量和治疗决策带来严重影响。尽管有一些研究探讨了ITP中与危重出血相关的风险因素,但目前尚缺乏大样本数据、大规模多中心研究结果以及针对ITP患者... 详细信息

原发性免疫性血小板减少症(ITP)中少见但至关重要的危重出血事件,给患者的预后、生活质量和治疗决策带来严重影响。尽管有一些研究探讨了ITP中与危重出血相关的风险因素,但目前尚缺乏大样本数据、大规模多中心研究结果以及针对ITP患者致命出血事件的预测模型。本研究首次采用国际血栓与止血学会新提出的ITP致命出血标准,利用大样本数据开发了首个基于机器学习的在线应用,用于预测ITP患者的致命出血.研究中,我们使用中国各地大型多中心数据进行开发,并对全国39家医疗中心进行为期一年的外部测试,得到了较好的训练、验证和测试数据集预测能力该基于新算法的便捷网络工具能够快速识别ITP患者的出血风险,辅助临床决策,有望未来降低不良事件的发生。

关键词： Critical bleeding Severe bleeding Immune thrombocytopenia Machine learning Prediction model

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Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma

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World Journal of Gastroenterology 2009年第47期15卷 5976-5982页

作者： Wei-feng Shen Wei Zhong feng Xu Tong Kan li Geng Feng Xie Cheng-Jun Sui Jia-Mei Yang department of special treatment Eastern Hepatobiliary Surgery Hospital Second Military Medical University 225 Changhai Road Shanghai 200438 China department of Gastroenterology Changzheng Hospital Second Military Medical University 415 Fengyang Road Shanghai 200003 China

AIM:To understand the clinicopathological characteristics and treatment selections and improve survival and provide valuable information for patients with intrahepatic cholangiocarcinoma(ICC). METHODS:We retrospectively evaluated 5311 liver cancer patients who received resection between October 1999 and December 2003.Of these,429(8.1%)patients were diagnosed with ICC,and their clinicopathological, surgical,and survival characteristics were analyzed. RESULTS:Upper abdominal discomfort or pain(65.0%), no symptoms(12.1%),and hypodynamia(8.2%)were the major causes for medical attention.Laboratory tests showed 198(46.4%)patients were HBsAg positive, 90(21.3%)hadα-fetoprotein>20μg/L,50(11.9%) carcinoembryonic antigen>10μg/L,and 242(57.5%) carbohydrate antigen 19-9(CA19-9)>37 U/mL.Survival data was available for 329(76.7%)patients and their mean survival time was 12.4 mo.The overall survival of the patients with R0,R1 resection and punching exploration were 18.3,6.6 and 5.6 mo,respectively. Additionally,CA19-9>37 U/mL was associated with lymph node metastases,but inversely associated withcirrhosis.Multivariate analysis indicated that radical resection,lymph node metastases,macroscopic tumor thrombi and size,and CA19-9 were associated with prognosis. CONCLUSION:Surgical radical resection is still the most effective means to cure ICC.Certain laboratory tests(such as CA19-9)can effectively predict the survival of the patients with ICC.

关键词：临床病理肝癌胆管预后平均存活时间癌胚抗原 HBsAg 临床特点

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