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