临床外科杂志 ›› 2022, Vol. 30 ›› Issue (10): 935-939.doi: 10.3969/j.issn.1005-6483.2022.10.010

• 论著 • 上一篇    下一篇

影像学危险因素对儿童腹部神经母细胞瘤手术指导及术后并发症预测价值研究

  

  1. 810001 青海省西宁妇女儿童医院放射科
  • 收稿日期:2021-11-03 修回日期:2021-11-03 出版日期:2022-10-20 发布日期:2022-10-20

Study on the value of imaging risk factors in guiding operation and predicting postoperative complications of abdominal neuroblastoma in children

  1. Department of Radiology,Qinghai Women and Children’s Hospital,Qinghai,Xining 810001,China
  • Received:2021-11-03 Revised:2021-11-03 Online:2022-10-20 Published:2022-10-20

摘要: 目的 探究影像学定义的危险因素(image-defined risk factors,IDRFs)用于儿童腹部神经母细胞瘤手术指导及术后并发症预测的临床价值。方法 2018年1月~2020年2月我院肿瘤外科收治未经化疗且行手术治疗的腹部神经母细胞瘤患儿77例,采用IDRFs分期法对儿童腹部神经母细胞瘤手术指导及Spearman、ROC曲线分析对术后并发症预测效能。结果 77例患儿按照INSS分期法划分I期24例,Ⅱ期41例,Ⅲ期12例。按照IDRFs分期法划分L1期26例,L2期51例。L1期与L2患儿手术完全切除率分别为80.77%和49.02%,术中输血分别为3例(11.54%)和20例(39.22%),差异有统计学意义(P<0.05);L2期患儿手术时间显著长于L1期,术中脏器损伤、浸润脏器切除、术中出血发生率显著高于L1期,术中并发症频次高于L1期,术后切口积液、切口血肿发生率显著高于L1期,术后并发症频次显著高于L1期,差异有统计学意义(P<0.05)。Spearman相关性分析表明,L1期与术后并发症存在中等相关性(r=0.416,P<0.05),L2期与术后并发症存在强相关性(r=0.711,P<0.05)。ROC曲线分析显示,L1期AUC为0.702,灵敏度为67.2%,特异度为65.1%;L2期AUC为0.887,灵敏度为86.2%,特异度为80.3%。结论 IDRFs分期法在术前评估及指导儿童腹部神经母细胞瘤手术治疗方式具有指导价值,对术后并发症预测具有重要价值。

关键词: 神经母细胞瘤, 影像学危险因素, 手术指导, 并发症, 预测

Abstract: Objective To explore the clinical value of image defined risk factors(IDRFs) in the surgical guidance and postoperative complication prediction of abdominal neuroblastoma in children.Methods A retrospective analysis of clinical data of 77 cases of abdominal neuroblastoma without chemotherapy and undergoing surgical treatment in our hospital from January 2018 to February 2020 was performed.The children were evaluated by IDRFs staging method,and the efficacy of IDRFS staging method in guiding the surgery of abdominal neuroblastoma in children and predicting postoperative complications was explored.Results According to INSS staging method,the 77 children were divided into stage Ⅰ(n=24),stage Ⅱ(n=41) and stage Ⅲ(n=12).According to the IDRFs staging method,there were 26 cases in stage L1 and 51 cases in stage L2.The complete surgical resection rates in stage L1 and L2 were 80.77% and 49.02%,respectively(P<0.05).Intraoperative blood transfusions in stage L1 and stage L2 were recorded in 3 cases(11.54%) and 20 cases(39.22%) respectively(P<0.05).The operation time in stage L2 was significantly longer than that in stage L1.The incidence of organ damage,invasive organ resection and intraoperative hemorrhage in stage L2 was significantly higher than that in stage L1(P<0.05).The frequency of intraoperative complications in stage L2 was significantly higher than that in stage L1(P<0.05).The incidence of incision effusion and hematoma in stage L2 was significantly higher than that in stage L1(P<0.05).The frequency of postoperative complications in stage L2 was significantly higher than that in stage L1(P<0.05).In Spearman’s correlation analysis,there was a medium correlation between stage L1 and postoperative complications(r=0.416,P<0.05),and a strong correlation between stage L2 and postoperative complications(r=0.711,P<0.05).ROC curve analysis showed that the AUC of stage L1 was 0.702,the sensitivity was 67.2%,and the specificity was 65.1%.Stage L2 AUC was 0.887,sensitivity was 86.2%,and specificity was 80.3%.Conclusion IDRFs staging is valuable to evaluate and guide the surgical treatment of pediatric abdominal neuroblastoma before surgery,and is important for predicting postoperative complications.

Key words: neuroblastoma, imaging risk factors, surgical guidance, complications, forecast

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