外周循环标志物在预测肝细胞癌腹腔镜肝部分切除术后早期并发症中的价值OA
Value of peripheral circulating biomarkers in predicting early postoperative complications after laparoscopic partial hepatectomy for hepatocellular carcinoma
目的:探讨外周循环标志物预测肝细胞癌腹腔镜肝部分切除术后早期并发症的临床价值.方法:回顾分析 2023年 1 月至 2024 年 12 月行腹腔镜肝部分切除术的肝细胞癌患者的临床资料,收集患者一般资料,术后第 1 天、第 3 天血清中性粒细胞计数、淋巴细胞计数、血小板计数、白蛋白、活化部分凝血活酶时间、ALT、AST、总胆红素水平,计算中性粒细胞/淋巴细胞比值(NLR)、全身免疫炎症指数(SII)、血小板与淋巴细胞比值(PLR)、预后营养指数(PNI).根据是否出现术后早期并发症分为并发症组(n=22)与无并发症组(n=76).比较不同时点 NLR、SII、PLR、PNI.根据受试者工作特征曲线评估 NLR 对早期并发症的预测准确性,并计算其灵敏度、特异度与截断值.结果:共纳入 98 例患者,22 例(22.45%)患者发生术后早期并发症.术后第 1 天、第 3 天,并发症组血清 NLR、ALT、AST、总胆红素及第 3 天活化部分凝血活酶时间高于无并发症组;术后第 1天,并发症组 PNI 水平低于无并发症组.多因素分析显示,术后第 1 天 NLR 是术后早期并发症的独立危险因素(OR=1.087,95%CI=1.019～1.158,P=0.010).受试者工作特征曲线分析显示,术后第 1 天 NLR 预测术后早期并发症的曲线下面积为0.695,最佳截断值为 12.097,其灵敏度为 0.682,特异度为 0.737(95%CI=0.604～0.768).结论:术后第 1 天 NLR 对腹腔镜肝部分切除术后早期并发症具有一定的预测价值.
Objective:To explore the clinical value of peripheral circulating biomarkers in predicting early postoperative com-plications following laparoscopic partial hepatectomy for hepatocellular carcinoma.Methods:A retrospective analysis was conducted on clinical data of patients who underwent laparoscopic partial hepatectomy for hepatocellular carcinoma between Jan.2023 and Dec.2024.General baseline data of the patients were collected.The serum levels of neutrophil count,lymphocyte count,platelet count,albumin,ac-tivated partial thromboplastin time,ALT,AST and total bilirubin were detected on postoperative day 1 and day 3.The neutrophil-to-lym-phocyte ratio(NLR),systemic immune-inflammatory index(SII),platelet-to-lymphocyte ratio(PLR)and prognostic nutritional index(PNI)were calculated.All patients were divided into the complication group(n=22)and the non-complication group(n=76)acco-rding to the presence or absence of early postoperative complications.The levels of NLR,SII,PLR and PNI at different time points were compared between the two groups.Receiver operating characteristic(ROC)curve was plotted to evaluate the predictive accuracy of NLR for early complications,and the sensitivity,specificity and optimal cut-off value were calculated.Results:A total of 98 patients were en-rolled in the study,among whom 22 cases(22.45%)developed early postoperative complications.On postoperative day 1 and day 3,the complication group presented significantly higher serum NLR,ALT,AST and total bilirubin levels,as well as higher activated partial thromboplastin time on postoperative day 3 than the non-complication group.The PNI level of the complication group was significantly lower than that of the non-complication group on postoperative day 1.Multivariate analysis showed that NLR on postoperative day 1 was an independent risk factor for early postoperative complications(OR=1.087,95%CI=1.019～1.158,P=0.010).ROC curve analysis demonstrated that the area under the curve of NLR on postoperative day 1 for predicting early postoperative complications was 0.695,with an optimal cut-off value of 12.097,a sensitivity of 0.682,and a specificity of 0.737(95%CI=0.604～0.768).Conclusions:NLR on postoperative day 1 possesses certain predictive value for early postoperative complications after laparoscopic partial hepatectomy for hepatocellular carcinoma.
石琪;潘雅馨;孙晓宇;王华阳
山东大学第一临床学院,山东 济南,250012||山东大学齐鲁医院检验医学中心山东大学第一临床学院,山东 济南,250012||山东大学齐鲁医院检验医学中心山东大学第一临床学院,山东 济南,250012||山东大学齐鲁医院检验医学中心山东大学齐鲁医院检验医学中心
医药卫生
癌,肝细胞肝部分切除术外周循环标志物腹腔镜检查手术后并发症
Carcinoma,hepatocellularPartial hepatectomyPeripheral circulating biomarkersLaparoscopyPostoperative complications
《腹腔镜外科杂志》 2026 (5)
341-346,352,7
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