著者

Nakagawa Nobuhiko Yamada Suguru Sonohara Fuminori Takami Hideki Hayashi Masamichi Kanda Mitsuro Kobayashi Daisuke Tanaka Chie Nakayama Goro Koike Masahiko Fujiwara Michitaka Kodera Yasuhiro

出版者

Springer

雑誌

Annals of Surgical Oncology (ISSN:10689265)

巻号頁・発行日

vol.27, no.3, pp.887-895, 2020-03

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Background: Nutritional and immunological statuses are attracting increasing attention for their ability to predict surgical outcomes in various cancers. The Naples prognostic score (NPS) consists of the serum albumin level, total cholesterol level, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio and could be useful for predicting survival. Patients and Methods: We retrospectively analyzed 196 patients with pancreatic cancer who underwent curative R0/R1 resection with a surgery-first strategy between June 2003 and August 2016. The NPS of the patients was calculated from preoperative data, and the patients were then divided into three groups based on their NPS. Clinicopathological characteristics, surgical outcomes, and long-term survival were compared, and multivariate analysis of overall survival was conducted. Results: Of a total of 196 patients, 22 were classified into group 0 (NPS 0), 113 into group 1 (NPS 1 or 2), and 61 into group 2 (NPS 3 or 4). Median survival time was 103.4 months in group 0, 33.3 months in group 1, and 21.3 months in group 2. Significant survival differences were observed among the 3 groups (group 1 vs. 2, group 0 vs. 2, P = 0.0380, P = 0.0022, respectively). On multivariate analysis, NPS was identified as an independent prognostic factor [hazard ratio (HR) = 1.78; P = 0.0131]; however, there were no significant differences in the incidence of postoperative morbidity among the NPS groups. Conclusions: The NPS could be an easy scoring system and an independent preoperative predictor of survival.

著者

Hoshino Masami Haraguchi Yoshikura Hirasawa Hiroyuki Mizushima Iwanori Tanaka Chie Morita Yasumasa Yokoi Takehito Sakai Motohiro 星野 正己 ホシノ マサミ 水島 岩徳 ミズシマ イワノリ 田中 千絵 タナカ チエ 森田 泰正 モリタ ヤスマサ 横井 健人 ヨコイ タケヒト 酒井 基広 サカイ モトヒロ 原口 義座 ハラグチ ヨシクラ 平澤 博之 ヒラサワ ヒロユキ

出版者

千葉医学会

雑誌

千葉医学雑誌 (ISSN:03035476)

巻号頁・発行日

vol.82, no.3, pp.149-161, 2006-06-01

被引用文献数

1 3

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Seven non-septic and twenty-two septic ICU patients with glucose intolerance were investigated by using bedside-type artificial pancreas (AP). IC was measured by the glucose clamp method (GC) in which BG level was clamped at 80mg/dL with two step insulin infusion rate (IIR) of 1.12 and 3.36mU/kg/min. Results: 1) IC could be estimated by the following formula: IC (mL/kg/min) =⊿IIR/⊿I≒2240/(I3-I1), (⊿IIR (mU/kg/min): difference of the amount of exogenous insulin infusion, ⊿I (mU/L): difference of the blood concentration of exogenous insulin, I1 (I3): blood concentration of insulin when IIR is 1.12 (3.36) mU/kg/min), because the difference between blood concentration of endogenous insulin when IIR was 1.12 mU/kg/min and that when IIR was 3.36mU/kg/min was small enough to be neglected. 2) IC was increased in 11 septic patients (50%) and was within normal limits in 8 septic patients (36%). 3) Among the factors which have been reported to influence IC in chronic diseases (age, body mass index, hyperlipidemia, blood lactate level, thyroid hormone, growth hormone, cortisol, organ dysfunction and its related parameters, etc.), only cardiac index was positively correlated with IC (y=3.3x+4.0, n=22, r=0.63, P<0.002).Conclusions: Measurement of IC on critical patients was established with our modified GC with two step insulin infusion. Hyperdynamic state was considered to be closely related to the increased IC.