Journal of Investigative Surgery最新文献

{"title":"Enhancing Outcomes in Transarterial Embolization for Late Postpancreatectomy Hemorrhage: A Comparison of N-Butyl Cyanoacrylate with Mixed Embolic Agents Versus Mixed Embolic Agents Alone.","authors":"Heng Zhang, Feng Duan, Jin Xin Fu, Jin Long Zhang, Bing Yuan, Yan Wang, Jie Yu Yan, Li Min Meng, Liang Li, Mao Qiang Wang","doi":"10.1080/08941939.2025.2488133","DOIUrl":"https://doi.org/10.1080/08941939.2025.2488133","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to retrospectively compare the efficacy of transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) and conventional agents (microcoils, polyvinyl alcohol [PVA], or gelatin sponge) in the treatment of patients with late postpancreatectomy hemorrhage (late-PPH).</p><p><strong>Methods: </strong>From June 2012 to June 2022, this retrospective study enrolled 130 consecutive patients who underwent TAE treatment due to late-PPH at one institution. Of these patients, 56 were treated with NBCA-mixed conventional agents (NBCA-MA group), and 74 were treated with mixed conventional agents alone (MA group). The patients' clinical characteristics and TAE details were gathered. The clinical outcomes in the two groups were compared. Using univariate and multivariate logistic regression analyses, prognostic factors were evaluated for clinical success and 30-day mortality rates.</p><p><strong>Results: </strong>The clinical success in the NBCA-MA group was 80.4% higher than that in the MA group (60.8%). Rebleeding was significantly more common in the MA group (29.7% vs. 8.9%). The 30-day mortality rate of the NBCA-MA group was lower than that of the MA group (16.1% vs. 33.8%). NBCA use was a significant prognostic factor associated with clinical success, while age and NBCA use were significant factors associated with the 30-day mortality rate.</p><p><strong>Conclusion: </strong>In conclusion, we found that TAE with NBCA is a safe and effective method for treating late-PPH.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2488133"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study.","authors":"Zachary R Bergman, Roy K Kiberenge, Richard W Bianco, Gregory J Beilman, Colleen M Brophy, Kyle M Hocking, Bret D Alvis, Eric S Wise","doi":"10.1080/08941939.2024.2445603","DOIUrl":"https://doi.org/10.1080/08941939.2024.2445603","url":null,"abstract":"<p><strong>Background: </strong>Venous waveform analysis is an emerging technique to estimate intravascular fluid status by fast Fourier transform deconvolution. Fluid status has been shown proportional to <i>f</i>₀, the amplitude of the fundamental frequency of the waveform's cardiac wave upon deconvolution. Using a porcine model of distributive shock and fluid resuscitation, we sought to determine the influence of norepinephrine on <i>f</i>₀ of the central venous waveform.</p><p><strong>Methods: </strong>Eight pigs were anesthetized, catheterized and treated with norepinephrine after precipitation of endotoxemic hypotension, and subsequent fluid resuscitation to mimic sepsis physiology. Hemodynamic parameters and central venous waveforms were continually transduced throughout the protocol for post-hoc analysis. Central venous waveform <i>f</i>₀ before, during and after norepinephrine administration were determined using Fourier analysis.</p><p><strong>Results: </strong>Heart rate increased, while central venous pressure, pulmonary capillary wedge pressure and stroke volume decreased throughout norepinephrine administration (<i>p</i> < 0.05). Mean <i>f</i>₀ at pre-norepinephrine, and doses 0.05, 0.10, 0.15, 0.20 and 0.25 mcg/kg/min, were 2.5, 1.4, 1.7, 1.7, 1.6 and 1.4 mmHg², respectively (repeated measures ANOVA; <i>p</i> < 0.001). On post-hoc comparison to pre-norepinephrine, <i>f</i>₀ at 0.05 mcg/kg/min was decreased (<i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>As the performance of f₀ was previously characterized during fluid administration, these data offer novel insight into the performance of f₀ during vasopressor delivery. Central venous waveform <i>f</i>₀ is a decreased with norepinephrine, in concordance with pulmonary capillary wedge pressure. This allows contextualization of the novel, venous-derived signal f₀ during vasopressor administration, a finding that must be understood prior to clinical translation.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2445603"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11709120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Diagnosis-to-Treatment Interval on the Survival of Patients with Papillary Thyroid Cancer.","authors":"Tingting Wei, Hongbo Huang, Aijie Zhang, Heng Zhang, Lingquan Kong, Yunhai Li, Fan Li","doi":"10.1080/08941939.2025.2456463","DOIUrl":"10.1080/08941939.2025.2456463","url":null,"abstract":"<p><strong>Background: </strong>For papillary thyroid cancer (PTC) patients, no consensus has been reached for the impact of diagnosis-to-treatment interval (DTI) on patient survival outcomes. We evaluated the impact of DTI on prognosis among patients with PTC.</p><p><strong>Methods: </strong>Patients diagnosed as PTC were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2019. The initial treatment strategies include surgery, radiation therapy, chemotherapy, hormone, immunotherapy, and/or active surveillance according to the SEER. Patients were grouped as follows: (I) DTI 0 (interval < 1 month or immediate treatment), (II) DTI 1-3 months, (III) DTI 4-5 months, and (IV) DTI ≥6 months.</p><p><strong>Results: </strong>A total of 168,969 patients with PTC were included in this cohort study. Median follow-up time was 84.0 months. No significant overall survival (OS) difference was observed between patients with immediate treatment and DTI 1-3 months. However, DTI 4-5 months and ≥6 months were associated with poorer OS compared to patients with immediate treatment. Although Kaplan-Meier analysis suggested slight TCSS differences between the delayed and immediate treatment groups, these disappeared after adjusting for tumor characteristics and treatment factors.</p><p><strong>Conclusions: </strong>A short-term delay (1-3 months) had no significant impact on OS, whereas more than 3 months of DTI resulted in poorer OS. Notably, delayed treatment had no impact on TCSS. These findings suggest that short-term delays are unlikely to affect survival, supporting decision-making flexibility for patients with low-risk PTC within three months of diagnosis.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2456463"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Simulation and Three-Dimensional Model for the Operative Treatment of Tibiofibular Diaphyseal Fracture: A Randomized Controlled Clinical Trial.","authors":"Yin Zhang, Qing Bi, Li Zhang, Danjie Zhu","doi":"10.1080/08941939.2025.2463351","DOIUrl":"10.1080/08941939.2025.2463351","url":null,"abstract":"<p><strong>Background: </strong>In order to ascertain the safety and therapeutic efficacy of preoperative simulation in conjunction with three-dimensional (3D) printing modalities for the surgical management of tibiofibular diaphyseal fractures. We postulate that preoperative simulation and three-dimensional (3D) printing techniques have a significant impact on reducing the mean operative time, diminishing intraoperative blood loss, and decreasing the frequency of fluoroscopic.</p><p><strong>Material and methods: </strong>Sixty patients with tibiofibular diaphyseal fracture were divided into the conventional surgery group (<i>n</i> = 30) and the 3D printing group (<i>n</i> = 30). In the 3D printing group, preoperative equal-ratio fracture models prepared using the 3D printing technique were used to perform preoperative simulation, guide the real surgical operation, examine implant reduction and placement as well as preoperative plate/screw size. The operation time, intraoperative bleeding, frequency of fluoroscopies, Visual Analog Scale (VAS), and Johner-Wruhs Scale were recorded.</p><p><strong>Results: </strong>The operation time, blood loss, and the frequency of fluoroscopy during operation in the group with preoperative simulation and 3D printing were less than that in the conventional surgery group (<i>p</i> < 0.001). Meanwhile, the Visual Analog Scale (VAS) and Johner-Wruhs Scale were also improved in both groups.</p><p><strong>Conclusion: </strong>The findings indicated that preoperative simulation and three-dimensional (3D) printing may facilitate the treatment of tibiofibular diaphyseal fractures, potentially enhancing preoperative planning and contributing to the precision and personalization of the surgical procedure. Thus, the application of this technology possesses considerable promise for future utilization in clinical practice.</p><p><strong>Trial registry: </strong>Name of the registry: This study was registered in the Chinese Clinical Trial Registry; Trial registration number: ChiCTR2100052379.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2463351"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Single-Person Reset Fixed System for Pediatric Supracondylar Humeral Fractures: Case Series and a Meta-Analysis.","authors":"Di Shen, Manman Cui, Qiang Fu, Jiajia Lu, Xiaojian Shi","doi":"10.1080/08941939.2025.2488130","DOIUrl":"https://doi.org/10.1080/08941939.2025.2488130","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the feasibility and effectiveness of utilizing the single-person reset fixed system (RFS) for treating pediatric supracondylar humeral fractures (SHFs) to enhance surgical efficiency and reduce manpower requirements.</p><p><strong>Methods: </strong>A retrospective analysis of 10 pediatric SHF cases treated with the Single-Person RF was conducted from 2022 to 2023. The primary variables of interest were surgical time, fluoroscopy frequency, postoperative outcomes, and complication rates.</p><p><strong>Results: </strong>All patients achieved successful single-stage surgical reduction and fixation without additional surgeries. The surgical time was 55 min, with an average fluoroscopy frequency of 11.8 times. Postoperatively, Baumann's Angle ranged from 64 to 81 degrees, indicating restoration of normal joint mobility as Range of Motion (ROM) exceeded 90%. The meta-analysis highlighted the significant advantage of the Single-Person RFS in improving the excellent treatment rate with low heterogeneity.</p><p><strong>Conclusion: </strong>The single-person RFS demonstrates remarkable effectiveness in pediatric SHF treatment, evident through reduced surgical times, decreased fluoroscopy frequency, minimal complications, and positive functional recovery for patients. The findings emphasize the superiority of the single-person RFS in enhancing treatment outcomes, suggesting future optimization and potential broader applications in fracture management.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2488130"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Preoperative Noninvasive Index Prediction Model for TURP Surgical Outcomes in Patients with Benign Prostatic Hyperplasia.","authors":"Jiyao Yang, Hongjin Shi, Hui Zhan, Haifeng Wang, Xiaorong Yang, Yuan Liang, Ji Li, Qin Zhang, Guifu Zhang, Yidao Liu","doi":"10.1080/08941939.2025.2490536","DOIUrl":"https://doi.org/10.1080/08941939.2025.2490536","url":null,"abstract":"<p><strong>Background: </strong>To investigate the influence of preoperative noninvasive indexes on surgical outcomes of benign prostatic hyperplasia (BPH) patients and to establish a clinical prediction model.</p><p><strong>Methods: </strong>A total of 250 BPH patients treated with transurethral resection of the prostate (TURP) in our center from December 2020 to June 2023 were included. The evaluation was completed by detailed history questionnaire, an international prostate symptom score (IPSS) assessment, and a urological ultrasonography.</p><p><strong>Results: </strong>Among included patients, 185 had effective outcomes, and 65 had ineffective outcomes, with an effective rate of 74%. Univariate and multivariate analyses identified IPSS-voiding/storage (IPSS-V/S) ratio, postvoid residual urine ratio (PVR-R), disease duration, intravesical prostatic protrusion (IPP), history of diabetes, history of urinary retention as independent predictive factors of surgical outcomes, which were further subjected to construct the prediction model. The receiver operating characteristic curve indicated an area under the curve of 0.894. The sensitivity and specificity of the model were 79.46% and 87.69%, respectively. Internal validation and the calibration curve indicated good agreement between the predicted and actual outcomes. Clinical decision curves found that the model had a more significant net clinical benefit than the \"all-intervention\" and \"no-intervention\" scenarios.</p><p><strong>Conclusion: </strong>The results suggested that BPH patients with a shorter disease duration, a larger IPSS-V/S, a larger IPP, a smaller PVR-R, and no history of diabetes or urinary retention were more likely to have a better outcome after TURP.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2490536"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect and Safety of Dexmedetomidine Administration on Mother and Foetus/Neonates During General Anaesthesia in Caesarean Section: A Randomised Controlled Trial.","authors":"Zhiqiang Yu, Yan Liu, Fangqi Duan, Qian Li, Dong Yan, Li Zhang, Zhuangzhuang Wang, Minyu Zhang, Qi Zhao","doi":"10.1080/08941939.2025.2495089","DOIUrl":"https://doi.org/10.1080/08941939.2025.2495089","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the safety of dexmedetomidine administration to mothers, fetuses, and neonates during general anesthesia in cesarean section (CS).</p><p><strong>Patients and methods: </strong>A total of 60 parturients scheduled for elective CS under general anesthesia were randomly divided into anesthesia in groups (DEX1 and DEX2) and control (C) groups. Groups DEX1 and DEX2 were induced with dexmedetomidine (induction, 0.4 µg/kg; maintenance, 0.4 µg/kg·h) and dexmedetomidine (induction, 0.6 µg/kg; maintenance, 0.6 µg/kg·h), respectively, until birth. Equivalent volumes of normal saline were administered in group C. Anesthesia was induced with propofol and rocuronium in all groups. The mean arterial blood pressure (MAP) and heart rate (HR) of parturients were monitored and recorded; fetal HR was monitored using color doppler ultrasound. The blood gas analysis from the umbilical artery (UA) and umbilical vein (UV), along with the HR, Apgar score and Neurologic Adaptive Capacity Scores (NACS) of neonates, were recorded.</p><p><strong>Results: </strong>Maternal MAP at intubation/skin incision, maternal HR at intubation/skin incision and delivery were significantly lower in groups DEX1 and DEX2 than in group C, no significant differences were observed between groups DEX1 and DEX2. No significant differences were observed in fetal HR, UA and UV blood gas analyses, Apgar score and NACS of neonates in the three groups.</p><p><strong>Conclusion: </strong>Intravenous 0.4 or 0.6 µg/kg doses of dexmedetomidine with propofol for general anesthesia in CS is beneficial for inhibiting the maternal stress response induced by intubation/skin incision and delivery without significant adverse effects on fetuses or neonates. Our findings suggest that dexmedetomidine is safe for mothers, fetuses, and neonates in obstetric general anesthesia.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2495089"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphadenectomy Does Not Improve Cancer-Specific Survival for Colorectal Cancer Patients Underwent Endoscopic Therapy: A Population-Based Retrospective Study.","authors":"Xiangying Deng, Yang Zhang, Xiong Guo, Lin Zhou, Xiangzhou Tan","doi":"10.1080/08941939.2025.2484540","DOIUrl":"https://doi.org/10.1080/08941939.2025.2484540","url":null,"abstract":"<p><strong>Methods: </strong>A total of 6626 patients with CRC who were initially referred for endoscopic polypectomy were enrolled from the Surveillance Epidemiology and End Results Database.</p><p><p><b>Results:</b> Most enrolled patients (6557/6626, 99.0%) were at T0-T1 stage (American Joint Committee on Cancer staging system). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to reduce selection bias, which resulted in balanced groups of patients with and without lymphadenectomy, with no difference in CSS (<i>p</i> = .99 and .074, respectively). In the subgroup analysis, insufficient lymphadenectomy (lymph node yield [LNY] < 12) was associated with poor CSS compared with no lymphadenectomy. The multivariate analysis identified adequate lymphadenectomy with an LNY ≥ 12 as an independent favorable prognostic factor. However, nearly half of the patients (59/127, 46.5%) referred for lymph node resection did not undergo adequate lymphadenectomy.</p><p><strong>Conclusions: </strong>The prognosis of CSS cannot be improved by lymphadenectomy for most patients (T0-T1) who are referred for endoscopic therapy because of the low rate of lymph node metastasis. Nonetheless, adequate lymphadenectomy should be performed instead of diagnostic lymph node resection if lymph node involvement is suspected.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2484540"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Energy Ultrapulse CO₂ Fractional Laser Combined with Autologous Platelet-Rich Plasma in Periorbital Rejuvenation Treatment.","authors":"Yanwen Qi, Cheng Sun, Yang Zhou, Lizhou Luo, Chengyuan Wang","doi":"10.1080/08941939.2025.2484543","DOIUrl":"https://doi.org/10.1080/08941939.2025.2484543","url":null,"abstract":"<p><strong>Objective: </strong>This paper focuses on the efficacy of low energy ultrapulsed CO₂ fractional laser (LEUCO₂FL) combined with autologous platelet-rich plasma (PRP) in periorbital rejuvenation treatment.</p><p><strong>Methods: </strong>Eighty patients with periorbital wrinkles and eyelid laxity were randomly assigned to a laser group (<i>n</i> = 40) receiving LEUCO₂FL or a combination group (<i>n</i> = 40) receiving additional autologous PRP. Both groups received treatment once per month for a total of three sessions. Cosmetic outcomes were assessed at three months post-treatment using the Global Esthetic Improvement Scale (GAIS). VISIA (wrinkles, texture), SOFT (skin elasticity, moisture), upper eyelid depression, and infraorbital hollowing were evaluated before and at 1, 3, and 6 months post-treatment. Adverse reactions and patient satisfaction were recorded.</p><p><strong>Results: </strong>The combination group exhibited higher overall effective rate of GAIS, greater improvements in wrinkles, texture, skin elasticity, and moisture at all time points, and lower upper eyelid depression and infraorbital hollowing scores than the laser group. While both treatments were well tolerated, patient satisfaction was higher in the combined group than the laser group.</p><p><strong>Conclusion: </strong>LEUCO₂FL combined with autologous PRP demonstrates favorable cosmetic effects in periorbital rejuvenation, significantly improving periorbital wrinkles and texture, enhancing skin elasticity and hydration, and reducing periorbital hollowness.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2484543"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and Validation of Diagnostic Model of Microvascular Invasion in Solitary Hepatocellular Carcinoma.","authors":"Xiu-Qin Wang, Ying-Qi Fan, Dong-Xing Hou, Cui-Cui Pan, Ni Zheng, Yuan-Quan Si","doi":"10.1080/08941939.2025.2484539","DOIUrl":"https://doi.org/10.1080/08941939.2025.2484539","url":null,"abstract":"<p><strong>Background: </strong>The microvascular invasion (MVI) score evaluates the presence of MVI in patients with hepatocellular carcinoma (HCC) by integrating multiple factors associated with MVI. We aimed to establish a MVI scoring system for HCC based on the clinical characteristics and serum biomarkers of patients with HCC.</p><p><strong>Methods: </strong>A total of 1027 patients with HCC hospitalized at Shandong Provincial Hospital from January 2016 to August 2021 were included and randomly divided into the development group and validation group at a ratio of 3:1. Univariable and multivariable logistic regression analyses were conducted to identify independent risk factors for MVI in HCC patients. Based on these independent risk factors, the preoperative MVI scoring system (diagnostic model) for HCC was established and verified. The receiver operating characteristic (ROC) curves, calibration curves and decision curve analyses (DCA) were employed to evaluate the discrimination and clinical application of the diagnostic model.</p><p><strong>Results: </strong>Independent risk factors for MVI of HCC involved Hepatitis B virus infection (HBV), large tumor diameter, higher logarithm of Alpha-fetoprotein (Log AFP), higher logarithm of AFP-L3% (Log AFP-L3%), higher logarithm of protein induced by vitamin K absence or antagonist-II (Log PIVKA-II) and higher logarithm of Carbohydrate antigen 125 (Log CA125). The diagnostic model incorporating these six independent risk factors was finally established. The areas under the ROC curve (AUC) assessed by the nomogram in the development cohort and validation cohort were 0.806 (95% CI, 0.773-0.839) and 0.818 (95% CI, 0.763-0.874) respectively. The calibration curve revealed that the results predicted by our diagnostic model for MVI in HCC were highly consistent with the postoperative pathological outcomes. The DCA further indicated promising clinical application of the diagnostic model.</p><p><strong>Conclusion: </strong>An effective preoperative diagnostic model for MVI of HCC based on readily available tumor markers and clinical characteristics has been established, which is both clinically significant and easy to implement for diagnosing MVI.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2484539"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}