FRS系统对胰十二指肠切除术后胰瘘的预测价值

Predictive Value of FRS System for Pancreatic Fistula after Pancreaticoduodenectomy

目的探讨胰瘘风险评分(Fistula Risk Score,FRS)系统对胰十二指肠切除术后胰瘘的预测价值。方法回顾性分析2016年6月-2018年6月于新疆医科大学第一附属医院胰腺外科行胰十二指肠切除术患者的完整临床与病理资料,利用FRS系统进行胰瘘风险评分,应用ROC曲线分析FRS系统对胰瘘发生的预测价值。结果104例PD患者中,术后胰瘘发生率为48.0%(50/104),其中生化瘘30例(28.8%)、临床相关胰瘘(B、C级胰瘘)20例(19.2%)。FRS系统预测术后胰瘘的灵敏度为71.1%,特异度为59.6%,AUC为0.655(95%CI:0.5470.764);FRS≥3分预测临床相关胰瘘的灵敏度为51.4%,特异度为80.3%,AUC为0.700(95%CI:0.5860.814)。结论FRS系统对术后胰瘘发生有一定的预测价值,且FRS≥3分时对临床相关胰瘘有较好的预测价值。

Objective To identify the predictive value of the Fistula Risk Scoring(FRS)system for pancreatic fistula after pancreaticoduodenectomy(PD).Methods All clinical and pathological data of PD patients admitted to the Department of Pancreatic Surgery,the first affiliated hospital of Xinjiang Medical University from June 2016 to June 2018 were retrospectively analyzed.The FRS system was used to evaluate the risk of pancreatic fistula.The ROC curve was used to analyze the predictive value of FRS system for pancreatic fistula.Results Among 104 PD patients,the incidence of postoperative pancreatic fistula(POPF)was 48.0%(50/104),including 30 cases(28.8%)with biochemical fistula(Grade A),and 20 cases(19.2%)with clinically related pancreatic fistula(CO-POPF,Grade B and C).The sensitivity of the FRS system to predict postoperative pancreatic fistula was 71.1%,the specificity was59.6%,and the AUC was 0.655(95%CI:0.547-0.764).The sensitivity of FRS≥3 points to predict clinically relevant pancreatic fistula was 51.4%,the specificity was 80.3%,and the AUC was 0.700(95%CI:0.586-0.814).Conclusions The FRS system has a certain predictive value for the occurrence of postoperative pancreatic fistula,and FRS≥3 has a better predictive effect on clinically relevant pancreatic fistula.