Cr-POSSUM评分系统对直肠癌手术患者的预测价值
Predictive Value of Cr-POSSUM Scoring Systems in Patient with Rectal Cancer after Surgery
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摘要: 目的 评价Cr-POSSUM对直肠癌患者术后死亡率的预测价值.方法 选取2013年10月至2015年10月期间,在昆明医科大学第二附属医院诊断为结肠恶性肿瘤及直肠恶性肿瘤并接受手术治疗的276例患者.根据Cr-POSSUM评分中各参数的分值计算总分.总分≤17分定义为低危患者,总分≥18分定义为高危患者.采用受试者工作特征曲线(ROC曲线)下面积(AUC值)和预测和实际病死率的比值(E:O)2种方法评估其准确性.结果在高危组患者和低危组患者的比较中,年龄、PS评分,OS评分,术后30 d病死率和术中出血量的差异有统计学意义(P<0.05).结论 Cr-POSSUM可准确预测直肠癌患者的术后死亡率.Abstract: Objective To evaluate the predictive value of Cr-POSSUM scoring systems in patients with rectal cancer after surgery. Methods 276 patients who underwent surgery with colorectal malignant neoplasms were divided into two groups depending on Cr-POSSUM total scores. Scores 17 points or less were defined as low-risk patients,scores more than 18 points were defined as a high-risk patients. The predicted results were compared with the actual situation by receiver-operating characteristic curve(ROC curve) and the ratio of expected mortality and obseved mortality to evaluate the accuracy. Results In the comparison of patients with high-risk group and low risk group,age, PS score, OS scores, postoperative bleeding and mortality in 30 day after surgery had a statistically significant difference(P<0.05). Conclusion Cr-POSSUM can accurately predict the postoperative mortality of patients with rectal cancer.
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Key words:
- Colorectal neoplasms /
- Colorectal surgery /
- Mortality /
- Risk prediction
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[1]任立焕,傅卫,王栋,等.结直肠癌患者住院期间病死率新评分系统的建立和评价[J],中华胃肠外科杂志,2008,11(3):213-218. [2]陈图锋,方佳峰,魏波,等.结直肠癌手术风险预测的临床应用评价[J],中山大学学报:医学科学版,2011,32(4):547-552. [3]张春,傅卫,任立涣,等.五种结直肠癌评分系统对中国患者的预测价值[J],中华普通外科杂志,2013,28(001):16-19. [4]任立焕,傅卫,王亮,等.POSSUM,P-POSSUM和Cr-POSSUM对结直肠癌患者住院期间病死率预测能力的比较[J],中华普通外科杂志,2008,23(4):241-244. [5]曹霖,汪晓东,陈珊珊,等.ACPGBI结直肠癌术后风险评估模型临床应用的初步探索[J].中国普外基础与临床杂志,2008,22(9):646-651,655. [6] [6]PTEKKIS,DPRYTHERCH,H KOCHER,et al.Development of a dedicated risk adjustment scoring system for colorectal surgery(colorectal POSSUM)[J],British Journal of Surgery,2004,91(9):1174-1182. [7]尉洁.ROC曲线广义线性模型及其医学应用[D].太原:山西医科大学(硕士论文),2010. [8] [8]ELEUNG,AMFERJANI,AKITCHEN,et al.Risk-adjusted scoring systems can predict surgeons’performance in colorectal surgery[J],The Surgeon,2011,9(1):3-7. [9] [9]SMS,TCA,PE.Racial differences in colorectal cancer incidence and mortality in the women's health initiative.[J],Cancer Epidemiol Biomarkers Prew,2011,20(001):1368-1378. [10] [10]FBENEDIX,RKUBE,FMEYER,et al.Comparison of17,641 patients with right-and left-sided colon cancer:differences in epidemiology,perioperative course,histology,and survival[J].Dis Colon Rectum,2010,53(1):57-64. [11] [11]FJVAN DER SLUIS,EESPIN,FVALLRIBERA,et al.Predicting postoperative mortality after colorectal surgery:A novel clinical model[J].Colorectal disease 2014,16(8):631-639. -
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