结直肠癌手术风险预测的临床应用评价

【目的】 探讨POSSUM、P-POSSUM、Cr-POSSUM及APGBI 4种评分系统预测结直肠癌手术风险的效果。【方法】 应用POSSUM、P-POSSUM、Cr-POSSUM及APGBI评分系统对2005年7月至2010年3月中山大学附属第三医院胃肠外科行手术治疗的320例结直肠癌患者进行评分分析,预测手术并发症发生率和死亡率,同时绘制各评分系统预测并发症和死亡率的ROC曲线。【结果】 POSSUM评分系统预测并发症的发生率(126例、39.4%)及死亡率(32例、10%)分别显著高于实际并发症率(82例、25.6%,P < 0.01)及死亡率(9例、2.8%,P < 0.01),但老年患者的并发症预测发生率与实际发生率无统计学差异,其C-Index为0.767,最佳临界值为45%、P-POSSUM、Cr-POSSUM及APGBI评分系统预测死亡率(分别为12例、3.8%,13例、4.1%及14例、4.4%)与实际死亡率(9例、2.8%)无统计学差异,其C-Index分别为0.872、0.906及0.936,最佳临界值分别为7%、5%及4%。【结论】 POSSUM评分系统能较准确地预测高危结直肠癌手术患者的并发症发生率,但过高预测死亡率,P-POSSUM、Cr-POSSUM及APGBI评分系统均能准确预测结直肠癌患者手术死亡率。

Evaluation of Clinical Application of Risk Prediction of Colorectal Cancer Resection

Objective] To evaluate the effect of POSSUM,P-POSSUM,Cr-POSSUM,and APGBI scoring systems in predicting risk of colorectal cancer resection.Methods] Clinical data of 320 cases of patients accepting surgery on colorectal cancer from July 2005 to March 2010 in Gastrointestinal Department of the Third Affiliated Hospital of Sun Yet-Sen University were collected both pre-and intra-operatively.POSSUM,P-POSSUM,Cr-POSSUM and APGBI scoring systems were used to calculate scores and predict incidence of postoperativ...