目的系统评价趋化因子受体7(C-X-C chemokine receptor type 7,CXCR7)在肿瘤患者预后判断中的价值。方法计算机系统检索Pub Med、Web of Science、Embase、CBM、VIP、CNKI和Wan Fang数据库收录的所有肿瘤中CXCR7表达与患者临床预后关系...目的系统评价趋化因子受体7(C-X-C chemokine receptor type 7,CXCR7)在肿瘤患者预后判断中的价值。方法计算机系统检索Pub Med、Web of Science、Embase、CBM、VIP、CNKI和Wan Fang数据库收录的所有肿瘤中CXCR7表达与患者临床预后关系的文献,检索时间从建库至2017年5月30日。由两位研究者按照纳入和排除标准筛选文献并评价纳入研究质量后,应用RevMan5.1软件进行数据分析。采用风险比(HR)和95%可信区间(CI)评估CXCR7与总体生存期(OS)和无瘤生存期(DFS)的累积效应。结果最终共纳入19项研究,Meta分析结果显示:CXCR7高表达比CXCR7低表达或不表达的肿瘤患者总体生存期(HR=1.52,95%CI=1.31~1.77,P<0.01)和无瘤生存期(HR=6.80,95%CI=2.25~20.56,P=0.001)低。在胆囊癌、肝癌和胰腺癌等肿瘤患者中,CXCR7高表达均较低表达或不表达的患者总体生存期低,而CXCR7高表达的食管癌患者并未显示出比低表达的患者有更大的死亡风险(HR=1.39,95%CI:0.82~2.36),差异无统计学意义(P=0.216)。结论 CXCR7的表达对消化道肿瘤患者的总体生存期和无瘤生存期具有预测价值,可作为判断消化道肿瘤患者预后的指标。展开更多
Background Intra-operative cholangiography has been shown to be a sensitive and specific method of demonstrating bile duct stones. This study investigated the feasibility, safety, and clinical value of selective trans...Background Intra-operative cholangiography has been shown to be a sensitive and specific method of demonstrating bile duct stones. This study investigated the feasibility, safety, and clinical value of selective trans-cystic intra-operative cholangiography in primary suture following three-port laparoscopic common bile duct exploration, and identified the factors that positively predict the presence of common bile duct stones. Methods From January 2008 to January 2011, 252 of 1013 patients undergoing laparoscopic cholecystectomy received selective trans-cystic intra-operative cholangiography and primary suture following three-port laparoscopic common bile duct exploration. Their clinical data were analyzed retrospectively. Results All operations were successful and none was converted to open surgery. The intra-operative cholangiography time was （8.3±2.5） minutes, and the operative duration was （105.4±23.1） minutes. According to selective intra-operative cholangiography, the positive predictive values of current jaundice, small gallstones （〈0.5 cm） and dilated cystic duct （〉0.3 cm）, dilated common bile duct （〉0.8 cm）, history of jaundice or gallstone pancreatitis, abnormal liver function test, and preoperative demonstration of suspected common bile duct stones on imaging were 87%, 25%, 42%, 15%, 32%, and 75% for common bile duct stones, respectively. Patients with several factors suggestive of common bile duct stones yielded higher numbers of positive cholangiograms. Unexpected stones were found in 13 patients （5.2%） by intra-operative cholangiography. The post-operative hospital stay was （4.7±2.2） days. Post-operative bile leakage occurred in two cases, and these patients recovered by simple drainage for 3-7 days without re-operation. Of the 761 patients who underwent laparoscopic cholecystectomy alone, 5 （0.7%） presented with a retained common bile duct stone requiring intervention. The median follow-up was 12 months, and only one patient who once suffered from bile leakage presented with obstructive jaundice due to bile duct stenosis 6 months postoperatively. The other patients recovered without any serious complications. Conclusions Selective intra-operative cholangiography yields acceptably high positive results. It is a safe, effective, and minimally invasive approach in patients with suspected choledocholithiasis and primary suture following three-port laparoscopic common bile duct exploration.展开更多
文摘目的系统评价趋化因子受体7(C-X-C chemokine receptor type 7,CXCR7)在肿瘤患者预后判断中的价值。方法计算机系统检索Pub Med、Web of Science、Embase、CBM、VIP、CNKI和Wan Fang数据库收录的所有肿瘤中CXCR7表达与患者临床预后关系的文献,检索时间从建库至2017年5月30日。由两位研究者按照纳入和排除标准筛选文献并评价纳入研究质量后,应用RevMan5.1软件进行数据分析。采用风险比(HR)和95%可信区间(CI)评估CXCR7与总体生存期(OS)和无瘤生存期(DFS)的累积效应。结果最终共纳入19项研究,Meta分析结果显示:CXCR7高表达比CXCR7低表达或不表达的肿瘤患者总体生存期(HR=1.52,95%CI=1.31~1.77,P<0.01)和无瘤生存期(HR=6.80,95%CI=2.25~20.56,P=0.001)低。在胆囊癌、肝癌和胰腺癌等肿瘤患者中,CXCR7高表达均较低表达或不表达的患者总体生存期低,而CXCR7高表达的食管癌患者并未显示出比低表达的患者有更大的死亡风险(HR=1.39,95%CI:0.82~2.36),差异无统计学意义(P=0.216)。结论 CXCR7的表达对消化道肿瘤患者的总体生存期和无瘤生存期具有预测价值,可作为判断消化道肿瘤患者预后的指标。
文摘Background Intra-operative cholangiography has been shown to be a sensitive and specific method of demonstrating bile duct stones. This study investigated the feasibility, safety, and clinical value of selective trans-cystic intra-operative cholangiography in primary suture following three-port laparoscopic common bile duct exploration, and identified the factors that positively predict the presence of common bile duct stones. Methods From January 2008 to January 2011, 252 of 1013 patients undergoing laparoscopic cholecystectomy received selective trans-cystic intra-operative cholangiography and primary suture following three-port laparoscopic common bile duct exploration. Their clinical data were analyzed retrospectively. Results All operations were successful and none was converted to open surgery. The intra-operative cholangiography time was （8.3±2.5） minutes, and the operative duration was （105.4±23.1） minutes. According to selective intra-operative cholangiography, the positive predictive values of current jaundice, small gallstones （〈0.5 cm） and dilated cystic duct （〉0.3 cm）, dilated common bile duct （〉0.8 cm）, history of jaundice or gallstone pancreatitis, abnormal liver function test, and preoperative demonstration of suspected common bile duct stones on imaging were 87%, 25%, 42%, 15%, 32%, and 75% for common bile duct stones, respectively. Patients with several factors suggestive of common bile duct stones yielded higher numbers of positive cholangiograms. Unexpected stones were found in 13 patients （5.2%） by intra-operative cholangiography. The post-operative hospital stay was （4.7±2.2） days. Post-operative bile leakage occurred in two cases, and these patients recovered by simple drainage for 3-7 days without re-operation. Of the 761 patients who underwent laparoscopic cholecystectomy alone, 5 （0.7%） presented with a retained common bile duct stone requiring intervention. The median follow-up was 12 months, and only one patient who once suffered from bile leakage presented with obstructive jaundice due to bile duct stenosis 6 months postoperatively. The other patients recovered without any serious complications. Conclusions Selective intra-operative cholangiography yields acceptably high positive results. It is a safe, effective, and minimally invasive approach in patients with suspected choledocholithiasis and primary suture following three-port laparoscopic common bile duct exploration.
