本文推荐了一种术中主要按照肝表面最大硬化结节大小评估肝硬化程度的分级标准。肝脏表面最大硬化结节直径<0.4 cm 为轻度肝硬化;0.4～0.8 cm 为中度肝硬化;>0.8 cm,或肝脏明显缩小变形,为重度肝硬化。按照此标准分级,统计表明随...本文推荐了一种术中主要按照肝表面最大硬化结节大小评估肝硬化程度的分级标准。肝脏表面最大硬化结节直径<0.4 cm 为轻度肝硬化;0.4～0.8 cm 为中度肝硬化;>0.8 cm,或肝脏明显缩小变形,为重度肝硬化。按照此标准分级,统计表明随着肝硬化程度的加重,尽管手术切除的肝组织量减少,但术后出现肝功不全(尤其是重度肝功不全)发生率逐渐增加。提示根据我们的标准进行肝硬化的分级,术中评估肝储备功能有临床实用价值,有助于选择适当的手术方式,减少肝功能衰竭的发生。展开更多
AIM To provide a simple surrogate marker predictive of liver cirrhosis(LC).METHODS Specimens from 302 patients who underwent resection for hepatocellular carcinoma between January 2006 and December 2012 were retrospec...AIM To provide a simple surrogate marker predictive of liver cirrhosis(LC).METHODS Specimens from 302 patients who underwent resection for hepatocellular carcinoma between January 2006 and December 2012 were retrospectively analyzed. Based on pathologic findings, patients were divided into groups based on whether or not they had LC. Parameters associated with hepatic functional reserve were compared in these two groups using MannWhitney U-test for univariate analysis. Factors differing significantly in univariate analyses were entered into multivariate logistic regression analysis.RESULTS There were significant differences between the LC group(n = 100) and non-LC group(n = 202) in prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, cholinesterase, type Ⅳ collagen, hyaluronic acid, indocyanine green retention rate at 15 min, maximal removal rate of technitium-99 m diethylene triamine pentaacetic acid-galactosyl human serum albumin and ratio of mean platelet volume to platelet count(MPV/PLT). Multivariate analysis showed that prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin and hyaluronic acid, and MPV/PLT ratio were factors independently predictive of LC. The area under the curve value for MPV/PLT was 0.78,with a 0.8 cutoff value having a sensitivity of 65% and a specificity of 78%.CONCLUSION The MPV/PLT ratio, which can be determined simply from the complete blood count, may be a simple surrogate marker predicting LC.展开更多
文摘本文推荐了一种术中主要按照肝表面最大硬化结节大小评估肝硬化程度的分级标准。肝脏表面最大硬化结节直径<0.4 cm 为轻度肝硬化;0.4～0.8 cm 为中度肝硬化;>0.8 cm,或肝脏明显缩小变形,为重度肝硬化。按照此标准分级,统计表明随着肝硬化程度的加重,尽管手术切除的肝组织量减少,但术后出现肝功不全(尤其是重度肝功不全)发生率逐渐增加。提示根据我们的标准进行肝硬化的分级,术中评估肝储备功能有临床实用价值,有助于选择适当的手术方式,减少肝功能衰竭的发生。
文摘AIM To provide a simple surrogate marker predictive of liver cirrhosis(LC).METHODS Specimens from 302 patients who underwent resection for hepatocellular carcinoma between January 2006 and December 2012 were retrospectively analyzed. Based on pathologic findings, patients were divided into groups based on whether or not they had LC. Parameters associated with hepatic functional reserve were compared in these two groups using MannWhitney U-test for univariate analysis. Factors differing significantly in univariate analyses were entered into multivariate logistic regression analysis.RESULTS There were significant differences between the LC group(n = 100) and non-LC group(n = 202) in prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, cholinesterase, type Ⅳ collagen, hyaluronic acid, indocyanine green retention rate at 15 min, maximal removal rate of technitium-99 m diethylene triamine pentaacetic acid-galactosyl human serum albumin and ratio of mean platelet volume to platelet count(MPV/PLT). Multivariate analysis showed that prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin and hyaluronic acid, and MPV/PLT ratio were factors independently predictive of LC. The area under the curve value for MPV/PLT was 0.78,with a 0.8 cutoff value having a sensitivity of 65% and a specificity of 78%.CONCLUSION The MPV/PLT ratio, which can be determined simply from the complete blood count, may be a simple surrogate marker predicting LC.
