基于计算机断层扫描对阻塞性结直肠癌的评估阻塞性度的新评分系统
Xin-Chang Shang-Guan1, Jun-Rong Zhang1, Chao-Nan Lin2
1Department of Emergency Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.
World journal of gastrointestinal oncology
|March 17, 2025
概括
一个新的基于计算机断层扫描的阻塞性度 (CTOD) 评分系统有助于阻塞性结直肠癌 (OCRC) 治疗决策. 与主观的CROSS系统不同,CTOD有助于避免不必要的紧急干预和并发症.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 手术决策 - 手术决策
背景情况:
- 阻塞性结直肠癌 (OCRC) 的管理依赖于主观的结直肠阻塞评分系统 (CROSS).
- 由于CROSS缺乏客观参数,因此需要一个客观的基于计算机断层扫描的阻塞度 (CTOD) 评分系统用于OCRC.
- 评估CTOD在OCRC决策和预测中的作用至关重要.
研究的目的:
- 调查OCRC.中的CTOD和CROSS评分系统之间的相关性.
- 评估CTOD对患者短期和长期预后的影响.
- 确定CTOD在指导OCRC的手术前决策方面的实用性.
主要方法:
- 分析了173名OCRC患者的队列.
- 使用k-平均值,近距离到远距离阻塞比率,以及非体面积比例来计算CTOD.
- CTOD与CROSS集成,以评估紧急干预,并比较患者的治疗结果.
主要成果:
- CTOD 3级阻塞独立预测了短期不良结果 (OR = 3.390,P = 0.010),而CROSS等级没有.
- 在CTOD-CROSS综合系统中,非严重阻塞 (CTOD 1-2,CROSS 1-4) 显示出较高的紧急干预并发症率 (71.4%) 与非紧急 (41.8%).
- 术后肺炎在紧急干预组 (35.7%) 与非严重阻塞性组 (8.9%) 相比更频繁.
结论:
- 在OCRC中,CTOD评分系统对于手术前决策非常有价值.
- 使用CTOD可以帮助防止不必要的紧急干预和相关并发症.
- 在优化OCRC管理策略方面,CTOD已经证明了它的实用性.
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