可溶性抑制肿瘤生成素 2 是预测术后肝功能衰竭的指标。

IF 3.5 3区 医学 Q1 SURGERY
BJS Open Pub Date : 2024-05-08 DOI:10.1093/bjsopen/zrae043
Jing Wu, Shadike Apaer, Xiapukaiti Fulati, Dominique A Vuitton, Yunfei Zhang, Jiangduosi Payiziwula, Nuerzhatijiang Anweier, Tao Li, Kahaer Tuerxun, Tuerganaili Aji, Jinming Zhao, Yingmei Shao, Tuerhongjiang Tuxun, Hao Wen
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引用次数: 0

摘要

背景:肝切除术后肝功能衰竭仍是肝切除术后一种可能危及生命的并发症。可溶性抑制肿瘤生成素 2 是一种与损伤相关的生物标志物。该研究旨在评估肝切除术后可溶性抑制肿瘤生成素2的升高,以及它是否能预测肝切除术后肝衰竭:这是一项单中心回顾性研究,包括2015年至2019年期间接受肝切除术的所有患者。在手术前和术后第1、2、5和7天测量血浆中可溶性抑制肿瘤生成素2的浓度。肝切除术后肝功能衰竭根据国际肝脏外科研究小组进行定义,发病率根据克拉维恩-丁多分类法进行分级:共纳入173例患者(75例接受了大部切除术,98例接受了小部切除术);术后第1天,血浆中可溶性抑制肿瘤生成素2的水平从43.42(范围18.69-119.96)pg/ml升至2622.23(范围1354.18-4178.27)pg/ml(P<0.001)。术后第 1 天的可溶性抑癌基因 2 浓度可准确预测肝切除术后肝功能衰竭≥B 级(曲线下面积 = 0.916,P <0.001),其出色的表现不受基础疾病、肝脏病理状态和切除范围的影响。术后第 1 天可溶性抑瘤因子 2 预测肝切除术后肝功能衰竭≥B 级的临界值、敏感性、特异性、阳性预测值和阴性预测值分别为 3700、92%、85%、64% 和 97%。与可溶性抑制肿瘤性2低患者相比,可溶性抑制肿瘤性2高患者肝切除术后肝功能衰竭≥B级的发生率更高(64.3%(36人)对2.6%(3人)),克拉维恩-丁多IIIa发病率更高(23.2%(13人)对5.1%(6人)):结论:可溶性抑瘤因子2可作为肝切除术后肝功能衰竭的可靠预测指标,预测肝切除术后肝功能衰竭的程度最早可在术后第1天≥B级。它在控制肝损伤/再生方面的作用有待进一步研究。注册编号ChiCTR-OOC-15007210 (www.chictr.org.cn/)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Soluble suppression of tumourigenicity 2 as a predictor of postoperative hepatic failure.

Background: Posthepatectomy liver failure remains a potentially life-threatening complication after hepatectomy. Soluble suppression of tumourigenicity 2 is an injury-related biomarker. The aim of the study was to assess soluble suppression of tumourigenicity 2 elevation after hepatectomy and whether it can predict posthepatectomy liver failure.

Methods: This was a single-centre retrospective study including all patients who underwent a liver resection between 2015 and 2019. Plasma concentrations of soluble suppression of tumourigenicity 2 were measured before surgery and at postoperative days 1, 2, 5 and 7. Posthepatectomy liver failure was defined according to the International Study Group of Liver Surgery and the morbidity rate was graded according to the Clavien-Dindo classification.

Results: A total of 173 patients were included (75 underwent major and 98 minor resection); plasma levels of soluble suppression of tumourigenicity 2 increased from 43.42 (range 18.69-119.96) pg/ml to 2622.23 (range 1354.18-4178.27) pg/ml on postoperative day 1 (P < 0.001). Postoperative day 1 soluble suppression of tumourigenicity 2 concentration accurately predicted posthepatectomy liver failure ≥ grade B (area under curve = 0.916, P < 0.001) and its outstanding performance was not affected by underlying disease, liver pathological status and extent of resection. The cut-off value, sensitivity, specificity, positive predictive value and negative predictive value of postoperative day 1 soluble suppression of tumourigenicity 2 in predicting posthepatectomy liver failure ≥ grade B were 3700, 92%, 85%, 64% and 97% respectively. Soluble suppression of tumourigenicity 2high patients more frequently experienced posthepatectomy liver failure ≥ grade B (64.3% (n = 36) versus 2.6% (n = 3)) and Clavien-Dindo IIIa higher morbidity rate (23.2% (n = 13) versus 5.1% (n = 6)) compared with soluble suppression of tumourigenicity 2low patients.

Conclusions: Soluble suppression of tumourigenicity 2 may be a reliable predictor of posthepatectomy liver failure ≥ grade B as early as postoperative day 1 for patients undergoing liver resection. Its role in controlling hepatic injury/regeneration needs further investigation. Registration number: ChiCTR-OOC-15007210 (www.chictr.org.cn/).

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BJS Open
BJS Open SURGERY-
CiteScore
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