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论著

SNHG12在乙肝病毒X蛋白诱导肝癌发生中的作用研究

Study on the role of SNHG12 in the occurrence of hepatocarcinoma induced by hepatitis B virus X protein

:16-24
 
目的 探究长链非编码RNA SNHG12在乙肝病毒X蛋白(HBx)诱导肝癌发生过程中的作用。方法 把课题组构建的肝前体细胞14-19、EGFP-14-19、HBx-EGFP-14-19通过小鼠肝门静脉注射到体内;采用 qRT-PCR、Western blot 方法检测30 d,90 d,180 d,360 d小鼠肝脏组织及细胞模型中HBx、SNHG12以及下游调节基因的mRNA和蛋白表达情况;使用si-SNHG12干扰其表达,并通过CCK-8、划痕实验、transwell实验、流式细胞术观察其对体外表型影响;检测SNHG12及下游的 mRNA 和蛋白表达;HE染色观察小鼠肝组织切片。结果 qRT-PCR结果表明SNHG12、Notch1、Hes1在HBx-EGFP-14-19细胞及各时间段的小鼠肝组织中均上调(F=48.808,P<0.000 1;F=13.322,P<0.000 1);Western blot结果显示在HBx过表达细胞及动物模型中,受HBx诱导SNHG12表达升高后Notch1信号通路被激活,促凋亡因子Bax下调,抗凋亡因子Bcl-2上调,细胞周期因子CDK2和Cyclin E上调;抑制SNHG12表达后,qRT-PCR、Western blot实验结果显示SNHG12(t=22.746,P<0.000 1)及其上述基因表达均扭转,CCK-8实验显示细胞增殖受到明显抑制,流式细胞术检测显示细胞凋亡增多,划痕及transwell实验表明细胞迁移及侵袭减弱。结论 HBx通过上调SNHG12诱导Notch1表达,导致细胞增殖、周期和凋亡异常,从而促进肝癌的发生。
Objective In order to explore the role of long non-coding RNA SNHG12 in hepatitis B virus X protein (HBx) induced hepatocarcinogenesis. Methods The liver precursor cells 14-19, EGFP-14-19 and HBx-EGFP-14-19 constructed by the research group was injected into the body through the hepatic portal vein of KM mice; qRT-PCR and Western blot were used to detect the mRNA and protein expression of HBx, SNHG12 and downstream regulatory genes in liver tissues of 30 d, 90 d, 180 d and 360 d mice and cell models. Si-SNHG12 was used to interfere with SNHG12 expression in vitro, the mRNA and protein expression of SNHG12 and downstream genes were detected, and its effect on phenotype in vitro was observed by CCK-8, flow cytometry, scratch test and transwell test. HE staining was used to observe the liver sections of mice. Results qRT-PCR showed that SNHG12, Notch1 and Hes1 were up-regulated in HBx overexpression cells and mouse liver tissue at each time point (F=48.808,P<0.000 1;F=13.322,P<0.000 1); the results of Western blot showed that in HBx over-expressing cells and animal models, the expression of SNHG12 was increased induced by HBx, resulting in the activation of Notch1 signal pathway, the down regulation of pro-apoptotic factor Bax, anti-apoptotic factor Bcl-2, and the up-regulation of cell cycle factors CDK2, cyclin E. After inhibiting the expression of SNHG12, the results of qRT-PCR and Western blot showed that SNHG12 (t=22.746,P<0.000 1) and the above genes were inhibited; CCK-8 experiment showed that cell proliferation was significantly inhibited, flow cytometry showed that cell apoptosis increased, scratch experiment and transwell experiment showed that cell migration and invasion decreased. Conclusions HBx induced Notch1 expression by up regulating SNHG12, resulting in abnormal cell proliferation, cycle and apoptosis, so as to promote the occurrence of liver cancer.
论著

非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素

Occurrence of bone marrow suppression and its influencing factors in patients with non-small cell lung cancer undergoing chemotherapy

:61-63
 
目的 分析非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素。方法 回顾性分析2017年2月—2019年8月期间本院进行化疗治疗的80例非小细胞肺癌患者临床资料,统计非小细胞肺癌化疗患者骨髓抑制发生情况,并根据其情况分组;收集所有患者临床资料,分析非小细胞肺癌化疗患者骨髓抑制发生的相关影响因素。结果 80例非小细胞肺癌化疗患者中发生骨髓抑制45例,发生率为56.25%;经单因素及多项Logistic回归分析,年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移是非小细胞肺癌化疗患者发生骨髓抑制的影响因素(OR>1,P<0.05)。结论 年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移会增加非小细胞肺癌化疗患者骨髓抑制的发生风险,临床上可据此来制定合理的干预措施,以降低患者骨髓抑制的发生风险。
Objective To analyze the occurrence and influencing factors of bone marrow suppression in patients with non-small cell lung cancer (NSCLC) undergoing chemotherapy. Methods The clinical data of 80 patients with NSCLC who received chemotherapy in our hospital from February 2017 to August 2019 were retrospectively analyzed, the occurrence of bone marrow suppression in patients with NSCLC under chemotherapy was enrolled and grouped according to the situation; the clinical data of all patients were collected, the related influencing factors of bone marrow suppression in patients were analyzed. Results Among 80 cases of patients with NSCLC, 45 cases occurred bone marrow suppression, the incidence was 56.25%; after univariate and multivariate Logistic regression analysis, age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis were the influencing factors of bone marrow suppression in patients with NSCLC under chemotherapy (OR>1, P<0.05). Conclusions Age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis will increase the risk of bone marrow suppression in patients with NSCLC chemotherapy. Therefore, reasonable intervention measures can be carried out to reduce the risk.
临床诊疗

蒽环类药物序贯曲妥珠单抗治疗导致乳腺癌患者心脏毒性的相关危险因素研究

:105-108
 
目的 本文主要分析乳腺癌患者应用蒽环类药物序贯曲妥珠单抗治疗对其心脏毒性的相关危险因素,并按照危险因素选择合适患者的治疗方案。方法 研究纳入了2019年6月—2022年6月在本院接受治疗的300例乳腺癌患者,患者接受蒽环类药物序贯曲妥珠单抗治疗,按照患者治疗期间是否发生心脏毒性进行分组,即为11例发生心脏毒性(观察组),289例患者未发生心脏毒性(对照组)。记录2组患者个人基础资料、肿瘤分期、病史、蒽环类药物以及联合化疗等因素,通过Logistic回归逐一对各项因素展开分析,了解相关危险因素。结果 在本次研究分析中,心脏毒性发生例数为11例,发生率为3.67%。其中289例患者未出现心脏毒性,患者用药后未出现相关反应。2组患者在联合放疗、高脂血症、蒽环类药物种类均有差异,差异有统计学意义(P<0.05)。结论 乳腺癌患者应用蒽环类药物序贯曲妥珠单抗后,发生心脏毒性的几率升高,其危险因素主要包括高脂血症史、应用表柔比星治疗以及左胸放疗史。
论著

气道径向超声引导多维度联合检查对周围型肺癌的诊断价值

Value of radial probe endobronchial ultrasound guided multi-dimensional combined examination in the diagnosis of peripheral lung cancer

:35-40
 
目的 探讨气道径向超声(RP-EBUS)引导多维度联合检查对周围型肺癌的诊断价值。方法 选取2019年9月—2021年12月于佛山市第二人民医院确诊的74例周围型肺癌患者,分析RP-EBUS引导肺活检、支气管黏膜刷检、支气管肺泡灌洗细胞学及DNA甲基化检测等多维度联合检查对周围型肺癌的诊断阳性率及影响因素。结果 RP-EBUS引导肺活检、支气管黏膜刷检、支气管肺泡灌洗液细胞学、DNA甲基化检测对周围型肺癌的诊断阳性率分别为52.7%、47.3%、45.9%和51.4%,RP-EBUS引导多维度联合检查阳性率为71.6%,高于单一方法检查(P<0.05);RP-EBUS引导多维度联合检查病灶直径≥30 mm诊断阳性率高于病灶直径<30 mm (82.9% vs 57.6%),差异有统计学意义(P<0.05);RP-EBUS引导多维度联合检查在肺上叶、中叶/舌叶、下叶病灶的阳性率分别为69.7%、66.7%和76.9%,差异无统计学意义(P>0.05);联合检查中超声探及病灶的诊断阳性率高于超声未探及病灶(76.9% vs 33.3%),差异有统计学意义(P<0.05);病灶超声图像表现为中心均实型的联合检查诊断阳性率高于非中心均实型(86.0% vs 59.1%),差异有统计学意义(P<0.05)。结论 RP-EBUS引导多维度联合检查对周围型肺癌有更高的诊断阳性率,诊断阳性率与病灶大小、超声是否探及病灶及病灶超声图像特征有关,与病灶部位无关。
Objective To investigate the value of radial probe endobronchial ultrasound (RP-EBUS)guided multi-dimensional combined examination in the diagnosis of peripheral lung cancer. Methods A retrospective analysis of 74 patients with peripheral lung cancer which were diagnosed in Foshan Second People's Hospital from September 2019 to December 2021 was carried out. RP-EBUS guided biopsy, brushing biopsy, bronchus alveolar lavage cytology and DNA methylation detection results were analyzed to obtain the positive diagnosis rate and influencing factors. Results The positive rates of RP-EBUS guided biopsy, brushing biopsy, bronchus alveolar lavage cytology and methylation for peripheral lung cancer were 52.7%, 47.3%, 45.9% and 51.4%, respectively. The positive rate of RP-EBUS guided multi-dimensional combined detection was 71.6%, which was significantly higher than single detection (P<0.05). The positive rate of RP-EBUS multi-dimensional combined examination in lesions diameter ≥30 mm was higher than that of lesion diameter <30 mm (82.9% vs 57.6%, P<0.05). The positive rate of RP-EBUS guided multi-dimensional combined group in the upper lobe, middle lobe/lingual lobe, and lower lobe of the lung were 69.7%, 66.7% and 76.9%, respectively, with no significant difference (P>0.05). The positive rate of ultrasound detected lesion in combined group was higher than that of undetected lesions (76.9% vs 33.3%, P<0.05). The ultrasound images of solid center lesions had higher positive rates than that of non solid center lesions (86.0% vs 59.1%, P<0.05). Conclusions RP-EBUS guided multi-dimensional combined examination has a higher positive rate for diagnosis of peripheral lung cancer. The positive rate of diagnosis are related to the size of the lesion, whether the lesion is detected by ultrasound and the characteristics of the ultrasound image of the lesion, but not related to the location of the lesion.
论著

化疗联合调强放疗治疗老年(≥65岁)局部晚期鼻咽癌的临床疗效

Clinical efficacy of chemotherapy combined with intensity-modulated radiotherapy in the treatment of elderly(≥65 years old)locally advanced nasopharyngeal carcinoma

:40-44
 
目的 探析化疗联合调强放疗(IMRT)治疗老年(≥65岁)局部晚期鼻咽癌的临床效果。方法 选取2018年1月—2019年1月我院诊治的90例老年局部晚期鼻咽癌患者为研究对象,使用随机数表法将此90例患者分为观察组及对照组,各45例。观察组行IMRT,对照组行化疗联合IMRT,对比2组的效果。结果 2组的治疗总有效率均为100%,组间差异不显著(P<0.05)。观察组的生活质量改善率(93.33%)高于对照组(77.78%)(P<0.05)。对照组出现3~4级白细胞减少、呕吐、黏膜炎人数明显高于观察组(P<0.05),两者其他毒副反应比较无显著差异(P>0.05)。观察组的1年总体生存率(91.11%)及3年总体生存率(75.56%)均高于对照组(86.67%、68.89%)(P<0.05)。结论 对于老年局部晚期鼻咽癌,化疗联合IMRT相比单纯IMRT降低了远期生存率,增加了毒副反应并影响疗后生活质量的改善,不宜常规应用,单纯IMRT可能是更合适的治疗选择。
Objective To explore the clinical effect of chemotherapy combined with intensity modulated radiation therapy(IMRT)in the treatment of elderly(≥65 years old)locally advanced nasopharyngeal carcinoma.Methods The study was carried out from January 2018 to January 2019.During this period,90 elderly patients with locally advanced nasopharyngeal carcinoma who were diagnosed and treated in our hospital were selected as the research objects.The random number table method was used to divide the 90 patients into observation groups,and the control group,each with 45 cases.The observation group was treated with IMRT,and the control group was treated with chemotherapy combined with IMRT.The effects of the two groups were compared.Results The total effective rate of the two groups was 100%,and there was no significant difference between the two groups(P<0.05).The improvement rate of quality of life in the observation group(93.33%)was higher than that in the control group(77.78%,P<0.05).The number of grade 3-4 leukopenia,vomiting and mucositis in the control group was significantly higher than that in the observation group(P<0.05),and there was no significant difference in other side effects between the two groups(P>0.05).The 1-year overall survival rate(91.11%)and 3-year overall survival rate(75.56%)of the observation group were higher than those of the control group(86.67%,68.89%,P<0.05).Conclusions For locally advanced nasopharyngeal carcinoma in the elderly,chemotherapy combined with IMRT reduces the long-term survival rate,increases the toxic and side effects and affects the improvement of the quality of life after treatment.It is not suitable for routine application,and IMRT alone may be a more appropriate treatment choice.
专家综述

纳米药物重编程肿瘤相关巨噬细胞增强抗癌效果

Recent progress of nanoparticle reprogramming of tumor-associated macrophages(TAMs)to enhance anti-tumor activity

:1-13
 
肿瘤相关巨噬细胞(TAMs)是肿瘤微环境中最丰富的免疫细胞之一,M2-TAMs在肿瘤发生、发展、转移和治疗过程中发挥重要作用,被认为是肿瘤治疗中的重要靶点。已有的研究表明,通过将促肿瘤的M2-TAMs重编程为促炎的M1-TAMs可实现抑制肿瘤生长和转移。本综述在介绍TAMs与肿瘤治疗相关背景的基础上,重点关注纳米药物重编程TAMs增强抗肿瘤的研究进展。本文将从TAMs靶向递送各种活性物质进行重编程TAMs和纳米药物介导的异常肿瘤微环境调节的间接重编程TAMs两种方式,综述近年来基于纳米药物递送系统的调控策略及典型例子。
Tumor associated macrophages(TAMs)is one of the most abundant immune cells in the tumor microenvironment.M2-TAMs play an important role in tumor genesis,progression,metastasis and treatment,and is additionally a very important target in tumor therapy.Previous studies have shown that inhibition of tumor growth and metastasis can be achieved by reprogramming M2-TAMs to M1-TAMs.On the basis,this review focuses on the analysis progress of nano-drug reprogramming TAMs to boost anti-tumor.In this paper,we reviewed two methods of reprogramming TAMs for targeted delivery of various active substances and indirect reprogramming TAMs for abnormal tumor microenvironment regulation mediated by nanomedicine.The regulatory strategies and typical samples of nanomedicine delivery systems in recent years were summarized.
论著

TIMELESS、RAB2A、ASPM在乳腺癌组织中的表达及与临床特征相关性

Expression of TIMELESS,RAB2A and ASPM in breast cancer and their correlation with clinical features

:80-86
 
目的 分析TIMELESS、鼠肉瘤病毒家族相关蛋白2A(RAB2A)、异常纺锤体样小头畸形相关基因(ASPM)在乳腺癌组织中的表达及与临床特征相关性。方法 选取2019年2月—2021年2月我院乳腺癌组织标本84例作为研究组、正常乳腺组织标本53例作为对照组,采用荧光定量聚合酶测定TIMELESS、ASPM,采用Western blot检测RAB2A蛋白表达情况,分析上述三个指标在乳腺癌中表达及与临床特征相关性。结果 对比对照组,研究组TIMELESS、ASPM表达较高,RAB2A较低(P<0.05)。TIMELESS、RAB2A、ASPM与乳腺癌淋巴结浸润、TNM分期、分化程度相关(P<0.05)。TIMELESS、RAB2A、ASPM为影响乳腺癌发生的危险因素(P<0.05)。TIMELESS、RAB2A负相关(r=-0.383、P=0.001);TIMELESS、ASPM正相关(r=0.397、P=0.001);RAB2A、ASPM负相关(r=-0.257、P=0.018)。对比TIMELESS、RAB2A、ASPM单一检测,三者联合检测对乳腺癌的诊断价值较高(P<0.05)。结论 乳腺癌患者TIMELESS、ASPM呈高表达,RAB2A呈低表达,上述三个指标与乳腺癌高度相关,可作为乳腺癌发生的检测指标。
Objective To analyze the expression of TIMELESS,murine sarcoma virus family related protein 2A(RAB2A)and abnormal spindle like microcephaly related gene(ASPM)in breast cancer tissues and their correlation with clinical features.Methods A total of 84 breast cancer tissue samples from our hospital from February 2019 to February 2021 were selected as the study group and 53 normal breast tissue samples were selected as the control group.Time,ASPM and RAB2A protein expression were determined by fluorescent quantitative polymerase,and RAB2A protein expression was detected by Western blot.The expression of the above three indicators in breast cancer and their correlation with clinical characteristics were analyzed.Results Compared with the control group,the study group had higher TIMELESS and ASPM expression levels and lower RAB2A level(P<0.05).TIMELESS,RAB2A and ASPM expressions were correlated with lymph node infiltration,TNM stage and differentiation of breast cancer(P<0.05).TIMELESS,RAB2A and ASPM were the risk factors of breast cancer(P<0.05).TIMELESS and RAB2A were negatively correlated(r=-0.383,P=0.001);TIMELESS and ASPM were positive correlated(r=0.397、P=0.001);RAB2A and ASPM were negatively correlated(r=-0.257,P=0.018).Compared with the single detection of TIMELESS,RAB2A and ASPM,the combined detection had higher diagnostic value for breast cancer(P<0.05).Conclusions Patients with breast cancer had high expression of TIMELESS and ASPM,and low expression of RAB2A.The above three indicators were highly correlated with breast cancer and can be detection indicators for breast cancer.
论著

MSCT增强扫描期相及VOI的选择在基于影像组学方法预测原发性肝细胞癌微血管侵犯中的价值

The value of contrast-enhanced MSCT with phases and VOI strategies in the prediction of microvascular invasion in primary hepatocellular carcinoma based on radiomics

:36-43
 
目的 基于影像组学方法,探讨多层螺旋CT(MSCT)四期增强扫描单一/不同期相及不同容积感兴趣区(VOI)的选择,在术前预测原发性肝细胞癌(HCC)微血管侵犯(MVI)中的价值。方法 回顾性收集88例经手术病理证实为HCC并行术前MSCT四期增强扫描的患者,其中包括47例MVI阳性患者和41例MVI阴性患者。在MSCT增强扫描的动脉早期、动脉晚期、门静脉期及延迟期图像中手动逐层勾画肿瘤ROI,获得瘤体容积感兴趣区VOI(Vt),然后基于计算机自动膨胀算法将Vt外扩10 mm获得瘤体及瘤周VOI(Vt+Vp)。使用Pyradiomics软件分别从Vt和Vt+Vp中提取影像组学特征,随后采用15种特征选择方法和10种分类器构建150个预测模型,并通过十折交叉检验以验证模型的效能。使用准确度、敏感度、特异度、受试者工作特性曲线下面积(AUC)评估模型的效能,并比较性能最优的前三个预测模型。结果 MSCT四期增强扫描图像中预测HCC MVI状态的影像组学模型在门静脉期的表现优于其它期相及各期相的不同组合,其中最大的AUC值在Vt和Vt+Vp两种ROI中分别为0.768和0.782。此外,基于Vt+Vp的影像组学模型对MVI的预测效能优于基于Vt的影像组学模型,基于Vt+Vp性能最优的预测模型的AUC值、准确度、敏感度和特异度分别0.782、0.728、0.745和0.705。结论 采用影像组学方法术前无创性预测HCC MVI状态首选增强扫描的门静脉期,ROI首选瘤体联合瘤周10 mm区域。
Objective To investigate the value of single or different phases of contrast-enhanced multi-slice spiral CT(MSCT)in different volumetric regions of interest(ROI)to preoperatively predict the state of microvascular invasion in primary hepatocellular carcinoma(HCC)based on radiomics methods.Methods A total of 88 patients with HCC confirmed by surgical pathology who underwent preoperative MSCT quadruple-enhanced scan were retrospectively recruited,including 47 MVI-positive patients and 41 MVI-negative patients.The ROI was manually delineated slice-by-slice in the early arterial phase,late arterial phase,portal venous phase,and equilibrium phase of enhanced MSCT images to obtain the volume of tumor VOI(Vt),and then Vt was expanded by 10 mm through the computer expansion algorithm automatically to obtain the volume of tumor and peritumor(Vt+Vp).Pyradiomics software was used to extract radiomic features from Vt and Vt+Vp,followed by 150 discriminant models constructed with 150 feature selection methods and 10 classifiers,and then 10-fold cross-validation was used to evaluate the performance of these models.Using accuracy,sensitivity,specificity,area under the receiver operating characteristic curve(AUC)to assess model performance.The top three predictive models with the best performance were also compared.Results The radiomics model for predicting HCC MVI status in portal venous phase among quadruple-enhanced MSCT images outperformed other phases and different combinations of phases,achieving the highest AUC values of 0.768 and 0.782 in Vt and Vt+Vp respectively.In addition,the prediction performance of the radiomics model based on Vt+Vp was superior to models based on Vt.AUC value,accuracy,sensitivity,and specificity of the model with the best performance based on Vt+Vp were 0.782,0.728,0.745 and 0.705 respectively.Conclusions Radiomics models based on the portal venous phase of contrast-enhanced MSCT and tumor combined with the 10mm peritumoral area were more recommended to be employed to preoperative non-invasively predict the state of HCC MVI.
论著

术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值

Application value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer

:28-35
 
目的 探讨术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值。方法 回顾分析统计2015年1月—2020年12月在江苏大学附属医院接受治疗的确诊胃癌患者,根据纳入标准和排除标准,选择入组患者,收集纳入研究患者一般资料、术前实验室检测数据和术后并发症情况,计算控制营养状况(CONUT)评分,统计分析CONUT营养评分在老年胃癌患者接受胃癌D2根治术术后短期并发症的价值。结果 共223例患者纳入研究,CONUT评分的截断值为2.5,肿瘤直径的截断值为2.75 cm。CONUT评分>2.5组的平均年龄高于CONUT评分<2.5组(P=0.005 3),且2组性别构成存在差异,男性患者多于女性(P=0.037 0)。CONUT评分>2.5组患者的肿瘤直径较大(P=0.039 4)。在术后并发症方面,CONUT评分>2.5组的术后并发症多于CONUT评分<2.5组(P=0.008 3)。单因素Logistic回归分析,年龄(OR=1.127;95%CI:1.028~1.236;P=0.011)、CONUT评分(OR=0.339;95%CI:0.151~0.764;P=0.009)是患者发生短期并发症的危险因素。多因素Logistic回归分析显示年龄(OR=1.115;95%CI:1.008~1.233;P=0.035)、CONUT评分(OR=0.414;95%CI:0.175~0.982;P=0.045)是患者发生短期并发症的危险因素。结论 CONUT评分作为老年胃癌患者术前营养评估项目可以有效预测患者术后短期并发症,进而提前进行营养干预,降低术后并发症发生率。
Objective To explore the value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer.Methods The data of patients who confirmed gastric cancer and treated in the Affiliated Hospital of Jiangsu University from January 2015 to December 2020 were reviewed and analyzed.Patients were selected according to the inclusion criteria and exclusion criteria,the general data,preoperative laboratory test data and postoperative complications of the included patients were collected,and the controlling nutritional status(CONUT)score was calculated.The value of CONUT score in the short-term complications of elderly gastric cancer patients undergoing D2 radical gastrectomy for gastric cancer was evaluated.Results A total of 223 patients were included in this study.The cut-off value of CONUT score was 2.5 and the cut-off value of tumor diameter was 2.75 centimeter.The average age of the group with CONUT score > 2.5 was significantly higher than that of the group with CONUT score < 2.5(P=0.005 3).Moreover,there was significant difference between the sex ratio of the two groups,with male more than female(P=0.037 0).The tumor diameter was significantly larger in the group with CONUT score > 2.5(P=0.039 4).In terms of postoperative complications,there was significantly more postoperative complications in the group with CONUT score > 2.5 than in the group with CONUT score < 2.5(P=0.008 3).Univariate logistic regression analysis showed that age(OR=1.127;95% CI:1.028-1.236;P=0.011)and CONUT score(OR=0.339;95% CI:0.151-0.764;P=0.009)were the risk factors for short-term complications.Multivariate logistic regression analysis showed that age(OR=1.115;95% CI:1.008-1.233;P=0.035)and CONUT score(OR=0.414;95% CI:0.175-0.982;P=0.045)were the risk factors for short-term complications.Conclusions As a preoperative nutritional evaluation item for elderly patients with gastric cancer,CONUT score can effectively predict the short-term postoperative complications of patients,and then carry out nutritional intervention in advance to reduce the incidence of postoperative complications.
综述

肝内胆管细胞癌诊治进展

Advances in diagnosis and treatment of intrahepatic cholangiocarcinoma

:100-105
 
肝内胆管细胞癌(ICC)是发病率仅次于肝细胞癌的肝脏恶性肿瘤,它的恶性程度高、术后易复发,且早期无典型症状,大多数患者在确诊时已处于晚期。诊断主要依赖于增强CT、MRI和实验室检查。肝切除术是ICC首选的治疗方法,完整的切缘阴性切除和保留足够残留肝是影响手术预后的重要因素。淋巴结清扫、卡培他滨辅助化疗已被证实对患者有益。局部治疗、分子靶向治疗、免疫治疗等新疗法发展迅速,为晚期ICC患者带来了希望。传统疗法与新疗法的结合为ICC提供新的诊疗思路。
Intrahepatic cholangiocarcinoma(ICC)is the second most common liver malignancy after hepatocellular carcinoma.It is highly malignant,easy to recur after surgery,and has no typical symptoms in the early stage,and most patients are in the late stage when diagnosed.Diagnosis relies on enhanced CT,MRI and laboratory tests.Hepatectomy is the preferred treatment for intrahepatic cholangiocarcinoma.Complete resection with negative margin and adequate residual liver preservation are important factors affecting the prognosis of the operation.Lymph node dissection and adjuvant chemotherapy with capecitabine have been shown to be beneficial for patients.The rapid development of new therapies such as local therapy,molecular targeted therapy and immunotherapy has brought hope to patients with advanced intrahepatic cholangiocarcinoma.The combination of traditional therapy and new therapy provide a new idea for diagnosis and treatment of intrahepatic cholangiocarcinoma.
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