AIM: To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis.
<strong>Background:</strong> Gastrointestinal hemorrhage from ruptured esophageal varices is of concern in Africa where gastrointestinal fibroscopy for diagnosis is lacking. <strong>Purpose:</stro...<strong>Background:</strong> Gastrointestinal hemorrhage from ruptured esophageal varices is of concern in Africa where gastrointestinal fibroscopy for diagnosis is lacking. <strong>Purpose:</strong> To determine the performance of the length of the spleen, of the platelet count in the diagnosis of esophageal varices (OVs) by specifying the diagnostic thresholds in order to facilitate the prophylaxis of varicose hemorrhages in black African cirrhotic patients. <strong>Material and Method:</strong> This was a prospective study with a descriptive and analytical aim on cirrhotic patients hospitalized at the university hospital of Bouake (Ivory Coast) from 2017 to 2019. The patients included in the study were the cirrhotic of black race hospitalized having carried out an abdominal ultrasound with measurement of the spleen diameter (SD), an eso-gastro-duodenal endoscopy, and a blood count with platelet count (PC). The first primary endpoint was the diagnosis of esophageal varices in cirrhosis. Cirrhosis was retained by the combination of clinical, biological, ultrasound and endoscopic arguments. The OVs were distributed according to size and the presence of red signs. The platelet count, and the measurement of the spleen to calculate the PC/SD ratio were the second endpoint. The secondary endpoints studied were, the viral and ethyl etiologies of the cirrhosis, the Chlid-Pugh prognostic score. Performance was assessed using the ROC curve. The difference was significant for p less than 0.05. <strong>Results:</strong> The study included 101 patients;they were 79 men (78.2%) and 22 women (21.8%). The mean age of the cirrhotic patients was 48 ± 14. Esophageal varices were present in (n = 93;92%) of cases. The different etiologies were hepatitis B virus (HBV) (n = 65;78.3%), hepatitis C virus (HCV) (n = 21;25, 3%), and alcohol (n = 6;7.2%). Platelet count (PC) < 100,000/mm3 was statistically related to the presence of OV with red signs. Splenomegaly (SD > 130 mm) and PC/SD ratio < 1000 were significantly related to the presence of OVs and large OVs. SD with a cutoff of > 102 mm predicted 75% of OVs (AUROC = 0.797). CP with a cutoff < 131,000/mm3, predicted 100% of OVs (AUROC = 0.756). The PC/SD ratio < 1205 diagnosed 100% of OV (AUROC = 0.801). The PC/SD ratio < 818 and SD > 129 mm predicted large OVs. <strong>Conclusion:</strong> Platelet count, spleen diamater, and PC/SD ratio were all performant for the diagnosis of OVs in our setting with better diagnostic performance for PC/SD. This report could help initiate prophylactic treatment for OVs rupture in cirrhotic patients in health centers where gastrointestinal endoscopy is lacking.展开更多
目的 分析血小板计数/脾脏直径比值、心排血量在预测肝硬化食管静脉曲张存在及出血的价值.方法 收集2007年5月至2012年5月福建医科大学附属漳州市医院肝硬化住院患者63例,其中男41例、女22例,年龄40 ～63岁.按胃镜检查结果分为曲张组（4...目的 分析血小板计数/脾脏直径比值、心排血量在预测肝硬化食管静脉曲张存在及出血的价值.方法 收集2007年5月至2012年5月福建医科大学附属漳州市医院肝硬化住院患者63例,其中男41例、女22例,年龄40 ～63岁.按胃镜检查结果分为曲张组（44例）与非曲张组（19例）,出血组（36例）与非出血组（27例）,分析组间血小板计数/脾脏直径比值、心排血量.结果 曲张组与非曲张组之间血小板计数/脾脏直径比值（0.46±0.33 vs 0.50±0.31）、心排血量差异（4973.73±1315.04 vs 4673.08±1907.95）均无统计学意义（P〉0.05）,出血组与非出血组之间血小板计数/脾脏直径比值（0.37±0.24 vs 0.42±0.39）差异有统计学意义（P〈0.05）、心排血量（5397.99±1107.03 vs 4730.73±1763.28）差异无统计学意义（P〉0.05）.结论 血小板计数/脾脏直径比值在预测食管静脉曲张破裂出血上有一定价值.展开更多
背景术前血小板计数,肿瘤最大径可辅助判断结直肠癌(colorectal cancer,CRC)患者预后,结合两者可在一定程度上取长补短,准确判断患者预后.但目前在临床上,对于联合这两个参数,如血小板计数和肿瘤最大径比(platelet count and maximum tu...背景术前血小板计数,肿瘤最大径可辅助判断结直肠癌(colorectal cancer,CRC)患者预后,结合两者可在一定程度上取长补短,准确判断患者预后.但目前在临床上,对于联合这两个参数,如血小板计数和肿瘤最大径比(platelet count and maximum tumor diameter ratio,PTR)是否可存在价值的报道较少.目的探讨术前PTR对CRC患者3年无进展生存期(progression free survival,PFS)的预测价值.方法收集解放军总医院海南医院自2012-12/2019-06经手术后病理确诊的结直肠腺癌患者127例,计算PTR并分析其在性别、年龄等不同临床临床参数中的差异和对PFS预测的价值.结果(1)PTR对患者3年PFS存在一定价值(AUC=0.66,95%CI:0.56-0.76,P<0.01),当其取值为57.27时,其对3年PFS预测的敏感性73.30%,特异性为56.10%;(2)以57.27为界,PTR高于界值的患者预后较好(Logrank=9.70,P<0.01),生存时间明显长于低于界值的患者(50.02 mo±22.33 mo vs 38.46 mo±24.39 mo,t=-2.76,P<0.01);(3)单因素分析显示术前癌胚抗原、糖类抗原199及TNM分期,PTR对患者生存存在影响(P<0.01),但多因素分析仅显示术前癌胚抗原、N及M分期是独立预测因子.结论PTR对CRC患者3年PFS预测存在一定价值,其中PTR较高的患者生存相对较好,但PTR不是患者预后的独立预测因子.展开更多
文摘AIM: To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis.
文摘<strong>Background:</strong> Gastrointestinal hemorrhage from ruptured esophageal varices is of concern in Africa where gastrointestinal fibroscopy for diagnosis is lacking. <strong>Purpose:</strong> To determine the performance of the length of the spleen, of the platelet count in the diagnosis of esophageal varices (OVs) by specifying the diagnostic thresholds in order to facilitate the prophylaxis of varicose hemorrhages in black African cirrhotic patients. <strong>Material and Method:</strong> This was a prospective study with a descriptive and analytical aim on cirrhotic patients hospitalized at the university hospital of Bouake (Ivory Coast) from 2017 to 2019. The patients included in the study were the cirrhotic of black race hospitalized having carried out an abdominal ultrasound with measurement of the spleen diameter (SD), an eso-gastro-duodenal endoscopy, and a blood count with platelet count (PC). The first primary endpoint was the diagnosis of esophageal varices in cirrhosis. Cirrhosis was retained by the combination of clinical, biological, ultrasound and endoscopic arguments. The OVs were distributed according to size and the presence of red signs. The platelet count, and the measurement of the spleen to calculate the PC/SD ratio were the second endpoint. The secondary endpoints studied were, the viral and ethyl etiologies of the cirrhosis, the Chlid-Pugh prognostic score. Performance was assessed using the ROC curve. The difference was significant for p less than 0.05. <strong>Results:</strong> The study included 101 patients;they were 79 men (78.2%) and 22 women (21.8%). The mean age of the cirrhotic patients was 48 ± 14. Esophageal varices were present in (n = 93;92%) of cases. The different etiologies were hepatitis B virus (HBV) (n = 65;78.3%), hepatitis C virus (HCV) (n = 21;25, 3%), and alcohol (n = 6;7.2%). Platelet count (PC) < 100,000/mm3 was statistically related to the presence of OV with red signs. Splenomegaly (SD > 130 mm) and PC/SD ratio < 1000 were significantly related to the presence of OVs and large OVs. SD with a cutoff of > 102 mm predicted 75% of OVs (AUROC = 0.797). CP with a cutoff < 131,000/mm3, predicted 100% of OVs (AUROC = 0.756). The PC/SD ratio < 1205 diagnosed 100% of OV (AUROC = 0.801). The PC/SD ratio < 818 and SD > 129 mm predicted large OVs. <strong>Conclusion:</strong> Platelet count, spleen diamater, and PC/SD ratio were all performant for the diagnosis of OVs in our setting with better diagnostic performance for PC/SD. This report could help initiate prophylactic treatment for OVs rupture in cirrhotic patients in health centers where gastrointestinal endoscopy is lacking.
文摘目的 分析血小板计数/脾脏直径比值、心排血量在预测肝硬化食管静脉曲张存在及出血的价值.方法 收集2007年5月至2012年5月福建医科大学附属漳州市医院肝硬化住院患者63例,其中男41例、女22例,年龄40 ～63岁.按胃镜检查结果分为曲张组（44例）与非曲张组（19例）,出血组（36例）与非出血组（27例）,分析组间血小板计数/脾脏直径比值、心排血量.结果 曲张组与非曲张组之间血小板计数/脾脏直径比值（0.46±0.33 vs 0.50±0.31）、心排血量差异（4973.73±1315.04 vs 4673.08±1907.95）均无统计学意义（P〉0.05）,出血组与非出血组之间血小板计数/脾脏直径比值（0.37±0.24 vs 0.42±0.39）差异有统计学意义（P〈0.05）、心排血量（5397.99±1107.03 vs 4730.73±1763.28）差异无统计学意义（P〉0.05）.结论 血小板计数/脾脏直径比值在预测食管静脉曲张破裂出血上有一定价值.
文摘背景术前血小板计数,肿瘤最大径可辅助判断结直肠癌(colorectal cancer,CRC)患者预后,结合两者可在一定程度上取长补短,准确判断患者预后.但目前在临床上,对于联合这两个参数,如血小板计数和肿瘤最大径比(platelet count and maximum tumor diameter ratio,PTR)是否可存在价值的报道较少.目的探讨术前PTR对CRC患者3年无进展生存期(progression free survival,PFS)的预测价值.方法收集解放军总医院海南医院自2012-12/2019-06经手术后病理确诊的结直肠腺癌患者127例,计算PTR并分析其在性别、年龄等不同临床临床参数中的差异和对PFS预测的价值.结果(1)PTR对患者3年PFS存在一定价值(AUC=0.66,95%CI:0.56-0.76,P<0.01),当其取值为57.27时,其对3年PFS预测的敏感性73.30%,特异性为56.10%;(2)以57.27为界,PTR高于界值的患者预后较好(Logrank=9.70,P<0.01),生存时间明显长于低于界值的患者(50.02 mo±22.33 mo vs 38.46 mo±24.39 mo,t=-2.76,P<0.01);(3)单因素分析显示术前癌胚抗原、糖类抗原199及TNM分期,PTR对患者生存存在影响(P<0.01),但多因素分析仅显示术前癌胚抗原、N及M分期是独立预测因子.结论PTR对CRC患者3年PFS预测存在一定价值,其中PTR较高的患者生存相对较好,但PTR不是患者预后的独立预测因子.
