Abstract
PurposeThis study aimed to explore the value of preoperative ultrasonography (US) in evaluating the peritoneal cancer index (PCI) of pseudomyxoma peritonei (PMP).MethodsAn ultrasound examination was performed on 59 patients with PMP before surgery, and the ultrasound PCI was evaluated. The accuracy of ultrasound PCI score was evaluated with the surgical PCI score as the gold standard.ResultsThe preoperative ultrasound PCI was compared with the surgical PCI. The Spearman correlation coefficient of the total PCI score was 0.608 (P < 0.05). The difference in the Spearman correlation coefficient between the preoperative ultrasound PCI and the surgical PCI in areas 0–7 was statistically significant. (1) Among them, the total score and the correlation between 0–3 and 6 were higher. (2) Compared with the surgical PCI, overestimation (> 20%) was concentrated mainly in areas 2 and 4–8 for 2 points, and underestimation (< 20%) was concentrated mainly in areas 1, 3, 4, and 8 for 3 points. (3) The sensitivity and specificity of preoperative ultrasound for predicting the presence or absence of lesions were 85.7% and 50.0%, respectively. The sensitivity of LS 1, LS 2, and LS 3 was 31.7%, 48.2%, and 71.0%, respectively, and the specificity was 44.8%, 55.3%, and 58.8%, respectively.ConclusionThe ultrasound examination can be used to score the preoperative PCI, judge the severity, and predict the prognosis in patients with PMP.
Highlights
Pseudomyxoma peritonei (PMP) is characterized by a large number of mucous jelly-like substances dispersed in the peritoneum or omentum, which is rare in clinical practice
From April 2017 to May 2018, 93 patients with PMP treated with cytoreduction surgery (CRS) + hyperthermic perioperative chemotherapy (HIPEC) were admitted to the hospital and underwent preoperative ultrasonography
19 patients undergoing at least 1 extensive resection before the surgery, 13 patients who did not obtain a surgical score (9 patients received chemotherapy after ascite drainage and 4 patients were transferred to other hospitals after puncture biopsy), and 2 patients
Summary
Pseudomyxoma peritonei (PMP) is characterized by a large number of mucous jelly-like substances dispersed in the peritoneum or omentum, which is rare in clinical practice. The annual incidence of PMP is only one million [1], and the most common position is the vermiform appendix (> 90%). It can be found in other organs such as the colorectum, gallbladder, stomach, pancreas, ovary, and urachus [2,3,4,5]. CT is of limited value in the diagnosis of small mucinous tumors, and the evaluation value of CT for preoperative PCI is limited. The purpose of this study was to predict the PCI by performing preoperative ultrasonography so as to better judge the severity of peritoneal disease and predict the prognosis of patients
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