CN107305596A - Patients with hilar cholangiocarcinoma prognostic predictive model - Google Patents
Patients with hilar cholangiocarcinoma prognostic predictive model Download PDFInfo
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Abstract
The present invention relates to patients with hilar cholangiocarcinoma prognostic predictive model.Specifically, the present invention provides a kind of carrier that Postoperative determination is carried out for patients with hilar cholangiocarcinoma, and the carrier is used for the fraction and patient 3 years survival rate Y3 and/or 5 years survival rate Y5 of the calculation risk factor；Wherein, risks and assumptions at least include patient age X, and the fraction of patient age, 3 years survival rates and 5 years survival rates meet the relation described in text.The present invention passes through the effect after the clinic of system thinking influence patients with hilar cholangiocarcinoma prognosis state, pathological characteristic, corrective surgery treatment, evaluate the key factor of influence patients with hilar cholangiocarcinoma survival region, set up the alignment table for patients with hilar cholangiocarcinoma survival region, for assessing postoperative 3 years of patient and the survival rate of 5 years, filter out people at highest risk to be intervened, improve the survival region of patient.
Description
Technical field
The present invention relates to patients with hilar cholangiocarcinoma prognostic predictive model.
Background technology
Cancer antigen CA19-9 is a kind of related to cancer of pancreas, cholangiocarcinoma, gallbladder cancer, colon cancer and stomach cancer etc.
Tumor markers, also known as intestines and stomach related antigen.It is a kind of for sialylated breast-N- rock algaes pentose II
The glycoprotein components of mucinoid, it is relevant with the haptens of lewis blood group compositions, molecular weight be 1,000,000~
5000000.Cancer antigen CA19-9 has higher sensitivity and preferably specificity to cancer of pancreas, and its positive rate exists
Between 85%~95%, and with Post operation with sb.'s illness took a favorable turn and reduce.At present, cancer antigen CA19-9 is mainly used
In the diagnosis to a variety of above-mentioned tumor in digestive tract and monitoring tumor recurrence, for the prognostic value of cholangiocarcinoma
Not yet obtain fully clearly.
Be presently used for hilar cholangiocarcinoma clinical stages standard mainly have Bismuth-Corlette, MSKCC,
Gazzaniga, TNM, Mayo clinic etc..Wherein Bismuth-Corlette, MSKCC and Gazzaniga
The acceptable operation of tumour that parting Staging System is mainly used in evaluating clinically patients with hilar cholangiocarcinoma is complete
The possibility of excision.And TNM, Mayo clinic are then mainly used in assessment patient's prognosis by stages.
The degree that Bismuth partings Staging System is developed in bile duct using tumour, as parting foundation, is first
The classification system for the guided operation scheme set up based on cholangiocarcinoma dissection and pathological characteristic is planted, it considers index letter
Single and reasonable, the operability and practicality in clinical preoperative evaluation are stronger.However, with clinical research
Progress find that hilar cholangiocarcinoma, which has, easily invades the pathology such as peripheral vessels and lymphatic metastasis such as portal vein
Feature, and Bismuth partings system only include tumor of bile duct in biliary system growing state this is single
Index, above-mentioned hazards are not considered, thus Bismuth partings system to assess Resection Rate and
The application values such as Postoperative determination judgement are very limited.
Gazzaniga Staging Systems incorporate tumor invading portal vein, hepatic arterial factor, meet Hilar
Cholangiocarcinoma easily invades the pathological anatomy feature of peripheral vessels, clinical practice situation of more fitting.But its
Define that system is unreasonable by stages, wherein the examination for unacceptable operation crowd is excessively strict, and do not have
The situation for judging lymphatic metastasis is included, it is limited to the predictive value of patient's prognosis.
MSKCC systems are based on Bismuth partings system and incorporate tumor invading portal vein this factor
The parting classification system of foundation, meets the anatomic characteristic that hilar cholangiocarcinoma easily invades peripheral vessels, by stages
System evaluation is simple, operability is stronger, is also easier to the receiving and accreditation for clinician.However, should
Staging System overemphasizes atrophy of liver lobe this feature, and hilar cholangiocarcinoma merges and occurs atrophy of liver lobe not
It is generally to occur and can not accomplish accurate evaluation, while the system is to be invaded portal vein situation classification not thin enough
Change, also the hazards not on the influence surgery excisions such as arteria hepatica infringement and lymphatic metastasis and prognosis are carried out
Take into full account, so have impact on this value by stages to hilar cholangiocarcinoma Index for diagnosis.
In summary, the parting Staging System such as Bismuth-Corlette, MSKCC, Gazzaniga is with liver
The position of door portion cholangiocarcinoma, portal vein are invaded, atrophy of liver lobe investigates object to be main, and it is mainly used in evaluating
Clinical hilar cholangiocarcinoma, which undergos surgery, cuts off the possibility for the treatment of, and to prediction tumour patient prognosis state valency
Value is limited.
TNM stage mainly investigate tumour to the Invasive depth of bile duct, lymphatic metastasis and far-end transfer shape
State, it is main to investigate the clinicopathological characteristics after tumour patient is treated surgically, yet with not including courage
The hazards of the influence prognosis such as the portal vein of pipe tumor is invaded, arteria hepatica infringement, so there is no method accurate
Assess, predict the prognosis situation of clinically tumour patient.
Mayo Clinic Staging System then mainly investigate patient condition, tumor size and number, vascular invasion,
Lymphatic metastasis, belly transfer and preoperative tumor markers CA19-9 levels etc. carry out clinical evaluation, prediction
The prognosis state of tumor patient.However, this does not consider arteria hepatica infringement, corrective surgery excision result (R0 by stages
Excision, R1 excisions and R2 excisions) etc. influence prognosis hazards, thus to patient's prognosis prediction not yet
Ideal, and its points-scoring system used is relatively complicated, causes its clinical practice to be not yet widely popularized.
The present invention by system thinking influence the clinic of patients with hilar cholangiocarcinoma prognosis state, pathological characteristic,
Other molecular marked compounds of effect and relative influence survival of patients prognosis after corrective surgery treatment, evaluate shadow
The key factor of patients with hilar cholangiocarcinoma survival region is rung, sets up pre- for patients with hilar cholangiocarcinoma existence
Alignment table afterwards, for assessing postoperative 3 years of patient and the survival rate of 5 years, filters out people at highest risk and enters
Row is intervened, and improves the survival region of patient.
The content of the invention
First aspect present invention provides a kind of carrier that Postoperative determination is carried out for patients with hilar cholangiocarcinoma, institute
Stating carrier is used for the fraction and patient 3 years survival rate Y3 and/or 5 years survival rate Y5 of the calculation risk factor；Its
In, risks and assumptions at least include patient age X；
Wherein, patient age X fraction is calculated as below：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；With
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
3 years survival rates are calculated as below：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；With
Overall score Z>173.5, then 3 years survival rate Y3<5%；
5 years survival rate satisfactions are calculated as below：
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；With
Overall score Z>134 points, then 5 years survival rate Y5<5%；
Wherein, overall score is the fraction sum of each risks and assumptions.
In one or more embodiments, the risks and assumptions also include lymphatic metastasis, surgical outcome,
CA19-9 levels (U/ml), portal vein are invaded and arteria hepatica is invaded.
In one or more embodiments, the lymphatic metastasis, surgical outcome, CA19-9 levels (U/ml),
The fraction that portal vein is invaded and arteria hepatica is invaded is calculated as below：
(a) lymphatic metastasis：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(b) surgical outcome：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(c) CA19-9 levels：
0-73.5U/ml, 0 point；
It is less than or equal to 325.0U/ml, 31.2 points more than 73.5；
More than 325.0U/ml, 50.0 points；
(d) portal vein is invaded：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(e) arteria hepatica is invaded：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points.
In one or more embodiments, the carrier is printed matter, such as card.
In one or more embodiments, the printed matter includes alignment table, and the alignment table includes fraction
Row, risks and assumptions row, overall score row and 3 years survival rate rows and/or 5 years survival rate rows, wherein, institute
Stating risks and assumptions row at least includes the age row with fraction row side by side, 3 years survival rate rows and/or life in 5 years
Deposit rate row and the overall score row side by side,
Wherein, the arrangement of fraction row and age row meets following relation：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；With
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
Arrangement between 3 years survival rate rows and overall score row meets following relation：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；
Overall score Z>173.5, then 3 years survival rate Y3<5%；With
Arrangement between 5 years survival rate rows and overall score row meets following relation：
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；With
Overall score Z>134 points, then 5 years survival rate Y5<5%.
In one or more embodiments, the scope of fraction row mid-score is 0-100 points, overall score
Capable fraction range is 0-400 points.
In one or more embodiments, the risks and assumptions also include lymphatic metastasis, surgical outcome,
CA19-9 levels (U/ml), portal vein are invaded and arteria hepatica is invaded.
Also include in one or more embodiments, on the printed matter it is following any one or more or it is complete
Portion's content：
(a) lymphatic metastasis：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(b) surgical outcome：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(c) CA19-9 levels：
0-73.5U/ml, 0 point；
It is less than or equal to 325.0U/ml, 31.2 points more than 73.5；
More than 325.0U/ml, 50.0 points；
(d) portal vein is invaded：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(e) arteria hepatica is invaded：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points.
In one or more embodiments, content (a)-(e) is provided in the way of word description
On printed matter, or can graphically it provide in the alignment table.
In one or more embodiments, the alignment table also includes the lymphatic metastasis with fraction row side by side
At least one of in row, surgical outcome row, CA19-9 horizontal lines, portal vein infringement row and arteria hepatica infringement row,
It is any multinomial or whole.
In one or more embodiments, the carrier is message processing device.
In one or more embodiments, described information processing equipment includes memory and processor, wherein,
The processor is configured to carry out following functions：
(I) fraction of each risks and assumptions is calculated according to following relation：
(1) age score：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
(2) lymphatic metastasis fraction：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(3) surgical outcome fraction：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(4) preoperative CA19-9 horizontal scores：
0-73.5U/ml, 0 point；
More than 73.5 and less than or equal to 325.0U/ml, 31.2 points；
More than 325.0U/ml, 50.0 points；
(5) portal vein invades fraction：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(6) arteria hepatica invades fraction：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points；
(II) the whole fractions summation obtained to (I), calculating obtains overall score Z；With
(III) 3 years survival rates (Y3) of patient or 5 years survival rates (Y5) are calculated according to following relation：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；
Overall score Z>173.5, then 3 years survival rate Y3<5%；
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；
Overall score Z>134 points, then 5 years survival rate Y5<5%.
In one or more embodiments, described information processing equipment also includes input unit, display device
And identifying device.
Second aspect of the present invention provides a kind of prognosis kit, and the kit includes detection hilar cholangiocarcinoma and suffered from
Person CA19-9 reagent, printed matter as described herein, and optional service manual.
Third aspect present invention provides CA19-9 detection reagents and is preparing the postoperative pre- of patients with hilar cholangiocarcinoma
The application in kit afterwards, wherein, the kit also contains printed matter as described herein and optional
Service manual.
Fourth aspect present invention provides a kind of method that Postoperative determination is carried out to patients with hilar cholangiocarcinoma, the party
Method includes：
(I) fraction of each risks and assumptions is obtained according to following relation：
(1) age score：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
(2) lymphatic metastasis fraction：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(3) surgical outcome fraction：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(4) preoperative CA19-9 horizontal scores：
0-73.5U/ml, 0 point；
More than 73.5 and less than or equal to 325.0U/ml, 31.2 points；
More than 325.0U/ml, 50.0 points；
(5) portal vein invades fraction：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(6) arteria hepatica invades fraction：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points；
(II) the whole fractions summation obtained to step (I), obtains overall score Z；With
(III) 3 years survival rates (Y3) of patient or 5 years survival rates (Y5) are calculated according to following relation：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；
Overall score Z>173.5, then 3 years survival rate Y3<5%；
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；
Overall score Z>134 points, then 5 years survival rate Y5<5%.
Brief description of the drawings
Fig. 1：The alignment table set up according to patients with hilar cholangiocarcinoma prognosis and Clinical symptoms.
Fig. 2：A) the 3 years overall survival rate dependence regression figures predicted and actually observed；B) prediction and
The 5 years overall survival rate dependence regression figures actually observed.
Fig. 3：The alignment table (Nomogram, F) and Bismuth-Corlette set up more herein in training set
(A), Gazzaniga (B), MSKCC (C), TNM stage (D) and Mayo Clinic be by stages
(E) difference in prognosis prediction.
Fig. 4：Prediction existence in 3 years of 93 patients with hilar cholangiocarcinoma (checking collection I) from same hospital
Rate and actual observation survival rate.
Fig. 5：Patient using the more different Staging Systems of Kaplan-Meier survivorship curves in checking collection I gives birth to
The quality in phase prediction is deposited, finds the alignment table (Nomogram) designed by the present invention compared to tradition by stages
System has significant advantage.
Fig. 6：84 patients with hilar cholangiocarcinoma (checking collection II) from affiliated hospital of Zhongshan University first
3 years prediction survival rates and actual observation survival rate.
Fig. 7：Using Kaplan-Meier survivorship curves, relatively different Staging Systems exist in checking collection II patient
Quality in life cycle prediction is it is again seen that the alignment table (Nomogram) designed by the present invention is compared to tradition
Staging System has significant advantage.
Embodiment
The application relates to the use of a kind of carrier to carry out prognosis to patients with hilar cholangiocarcinoma.
Herein, " carrier ", which refers to, is loaded with information described herein (such as alignment table described below) or execution
Function described herein is to obtain the product of fraction described herein and survival rate information.
Therefore, as an example, carrier can be the printed matter for being provided with alignment table, such as card.
Herein, " card " is often referred to the product of sheet, and its material can be papery or plastics or other materials.
The thickness of card is not limited, but from the point of view of convenient use, card should not be too thick.For example, card can be with
It is conventional paper sheet for printing, or for plastic tab, its thickness can be such as 1mm to 1cm or more
It is thin.
Alignment table can be printed onto card (such as on paper) with conventional printing technology, with it is not easy to apply,
Elution is advisable.Alignment table is typically at least included with fraction row risks and assumptions (at least including the age) side by side OK,
With the 3 years survival rate rows and/or 5 years survival rate rows with overall score row side by side,
Wherein, the arrangement of fraction row and age row meets following relation：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
Wherein, the arrangement between 3 years survival rate rows and overall score row meets following relation：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；
Overall score Z>173.5, then 3 years survival rate Y3<5%；
Arrangement between 5 years survival rate rows and overall score row meets following relation：
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；
Overall score Z>134 points, then 5 years survival rate Y5<5%.
In alignment table, the 0-100 that is generally in the range of of fraction row mid-score divides, the fraction model of overall score row
Enclose usually 0-400 points.
Risks and assumptions may also include lymphatic metastasis, surgical outcome, CA19-9 levels (U/ml), Men Jing
Arteries and veins is invaded and arteria hepatica is invaded etc..
Therefore, optionally, following any one or more or full content are also included on printed matter such as card：
(a) lymphatic metastasis：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(b) surgical outcome：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(c) CA19-9 levels：
0-73.5U/ml, 0 point；
It is less than or equal to 325.0U/ml, 31.2 points more than 73.5；
More than 325.0U/ml, 50.0 points；
(d) portal vein is invaded：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(e) arteria hepatica is invaded：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points.
The above (a)-(e) can be provided on printed matter such as card in the way of word description, also may be used
Graphically provide in the alignment table, for example, lymphatic metastasis row, hand with fraction row side by side
Art result row, CA19-9 horizontal lines, portal vein invade row and arteria hepatica invade in row at least one of, it is any
It is multinomial or whole.
Fig. 1 shows a specific embodiment of alignment table of the present invention.As shown in figure 1, alignment table is included simultaneously
Fraction row, age row, lymphatic metastasis row, surgical outcome row, CA19-9 horizontal lines, the portal vein of row is invaded
Violate row, arteria hepatica and invade row, overall score row, 3 years survival rate rows and 5 years survival rate rows, wherein, with
Age row, lymphatic metastasis row, surgical outcome row, CA19-9 horizontal lines, the portal vein of fraction row side by side are invaded
Violate row and arteria hepatica invade row in the way of meeting previously described corresponding relation side by side, and with overall score row
3 years survival rate rows and 5 years survival rate rows side by side then in the way of meeting previously described corresponding relation side by side.
During using the alignment table, can according to the age of patient, lymphatic metastasis, surgical outcome, CA19-9,
Risk score corresponding to the index of correlation such as portal vein infringement and arteria hepatica infringement, calculates every risks and assumptions and divides
Number sum, then against overall score row, vertical line is drawn downwards according to overall score and can obtain patient 3
The survival rate value in year and 5 years.Survival rate value is lower, then prognosis is poorer.
Because risks and assumptions lymphatic metastasis, surgical outcome, CA19-9 levels (U/ml), portal vein are invaded
Violate and each detection/inspection result of arteria hepatica infringement all only corresponds to a fraction determined, therefore, as before
It is literary described, lymphatic metastasis row, surgical outcome row, CA19-9 levels (U/ml) are may not include in alignment table
Row, portal vein invade row and arteria hepatica invades row, or only include one or several kinds therein.For alignment table
In row not to be covered, can provide in other suitable manners on printed matter such as card, such as with word description
Mode provide, or do not provide on printed matter such as card, but provide on such as service manual so that
User can easily know the fraction corresponding to each detection/inspection result of the risks and assumptions.
In preferred embodiment, every risks and assumptions and its corresponding fraction described previously all provide same
On printed matter (such as same card), no matter graphically or in the way of word description.Therefore,
In some preferred embodiments, the alignment table shown in Fig. 1 is printed with card of the invention.But, should
Understand, for example, overall score row and 3 years survival rate rows and/or 5 years survival rate rows may be provided in difference
Printed matter (such as card) on.Therefore, herein, " printed matter " and " card " itself can be
One or two or multiple.
Can clearly it be recognized in alignment table it should be understood that the size of printed matter (such as card) should be sufficient so that user
Each word and numerical value.When being printed with the alignment table shown in Fig. 1 on printed matter (such as card), alignment table
Big I zoomed in or out according to the size equal proportion of card.
Moreover, it will be understood that the corresponding word in alignment table, can be presented in the manner shown in fig. 1,
Can by it is well known in the art there are identical meanings in the way of present.For example, can be different language (Chinese,
English, Japanese etc.) form offer.
Carrier can also be a kind of message processing device, including such as memory and processor, wherein, it is described
Processor is configured to carry out following functions：
(I) fraction of each risks and assumptions is calculated according to following relation：
(1) age score：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
(2) lymphatic metastasis fraction：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(3) surgical outcome fraction：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(4) preoperative CA19-9 horizontal scores：
0-73.5U/ml, 0 point；
More than 73.5 and less than or equal to 325.0U/ml, 31.2 points；
More than 325.0U/ml, 50.0 points；
(5) portal vein invades fraction：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(6) arteria hepatica invades fraction：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points；
(II) the whole fractions summation obtained to (I), calculating obtains overall score Z；With
(III) 3 years survival rates (Y3) of patient or 5 years survival rates (Y5) are calculated according to following relation：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；
Overall score Z>173.5, then 3 years survival rate Y3<5%；
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；
Overall score Z>134 points, then 5 years survival rate Y5<5%.
Described information processing equipment may also include other parts well known in the art, including but not limited to input dress
Put, display device, identifying device etc..
Described information processing equipment can be hand-held or such as tablet personal computer.
Carrier can also be other suitable object forms, for example, it may be other various in addition to card
The printed matter of form, as long as it can allow those skilled in the art to readily calculate trouble according to methods described herein
The fraction of each risks and assumptions of person and 3 years survival rates and 5 years survival rates.In certain embodiments,
Carrier does not include described information processing equipment.
On the other hand the application also includes a kind of prognosis kit, and the kit includes detection hilar cholangiocarcinoma
Patient CA19-9 reagent, printed matter (such as card) as described herein, and optional service manual.Examination
Reagent in agent box is preferred for detecting the CA19-9 levels that patient is preoperative.Examination well known in the art can be used
Agent detects patient's CA19-9 levels.Herein, service manual can be that for example portion instructs user to make
The specification of patients with hilar cholangiocarcinoma Postoperative determination is carried out with the kit.
The alignment table on printed matter (such as card) in kit can only contain the age row with fraction row side by side,
With 3 years or 5 years survival rate rows with overall score row side by side, for other risks and assumptions difference values, institute is right
The fraction answered, it is possible to provide in the subsidiary service manual of kit.Certainly, on the printed matter in kit
Alignment table may also comprise all risks and assumptions rows, for example, can provide the card containing alignment table shown in Fig. 1.
This paper carrier and kit can be used for the Postoperative determination of patients with hilar cholangiocarcinoma.Every risks and assumptions,
Especially lymphatic metastasis, surgical outcome, CA19-9 levels (U/ml), portal vein are invaded and arteria hepatica
Invading all can be diagnosed or be detected by the conventional method in this area.
This paper another further aspect also provides CA19-9 detection reagents and is preparing the postoperative pre- of patients with hilar cholangiocarcinoma
The application in kit afterwards.Preferably, the kit also contains carrier as described herein, especially
The printed matter, and optional service manual.
Also include a kind of method that Postoperative determination is carried out to patients with hilar cholangiocarcinoma herein, this method includes：
(I) fraction of each risks and assumptions is obtained according to following relation：
(1) age score：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
(2) lymphatic metastasis fraction：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(3) surgical outcome fraction：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(4) preoperative CA19-9 horizontal scores：
0-73.5U/ml, 0 point；
More than 73.5 and less than or equal to 325.0U/ml, 31.2 points；
More than 325.0U/ml, 50.0 points；
(5) portal vein invades fraction：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(6) arteria hepatica invades fraction：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points；
(II) the whole fractions summation obtained to step (I), obtains overall score Z；With
(III) 3 years survival rates (Y3) of patient or 5 years survival rates (Y5) are calculated according to following relation：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；
Overall score Z>173.5, then 3 years survival rate Y3<5%；
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；
Overall score Z>134 points, then 5 years survival rate Y5<5%.
To the lymphatic metastasis of patient, surgical outcome, CA19-9 levels (U/ml), portal vein invade and
Arteria hepatica invade inspection/detection and inspection/testing result evaluation, for example with or without lymphatic metastasis,
Cut off as R0, R1 or R2, invaded with or without portal vein, or there is branch to invade or have trunk infringement, have or
Invaded without arteria hepatica, have branch is invaded or trunk is invaded etc., be that this area conventional meanses can be realized and determined.
Hereafter the present invention will be illustrated in the way of specific embodiment.It should be understood that these embodiments are only to illustrate
Property, not limit the scope of the invention.Method, reagent and the condition arrived used in embodiment,
Unless otherwise stated, being this area conventional method, reagent and condition.
Embodiment 1
1. experimental procedure
1.1 Mass screening
Hospital of attached east liver and gall surgical department of retrospective analysis The 2nd Army Medical College was in 2000 to 2009 years institutes first
The non-metastatic patients with hilar cholangiocarcinoma clinical information of diagnosis and treatment carries out the structure of prognostic model.Eliminating has
Intrahepatic cholangiocarcinoma, distal end cholangiocarcinoma, the tumour patient of metastatic cholangiocarcinoma patients and acatalepsia；Exclude
The patients with hilar cholangiocarcinoma that liver cancer patient is invaded patients with hilar cholangiocarcinoma, can not be treated surgically
(the Bismuth IV phases, or Bismuth IIIa and the IIIb phases and exist offside portal vein infringement operation it is absolute
The patient of contraindication)；Month after operation is also eliminated simultaneously because of the dead patient of postoperative complication.235 livers
Door portion cholangiocarcinoma patients, which meet inclusion criteria, turns into the training set for building prognostic predictive model herein.
From in January, 2010 in December, 2011, perspective have collected of inventor is treated surgically in the institute
Patients with hilar cholangiocarcinoma, and with and training set it is similar enter group and exclusion standard carried out examination, altogether
93 standard compliant patients with hilar cholangiocarcinoma are obtained, the checking collection I (Internal as research
validation)。
Inventor's also retrospective have collected 2005 to 2011 receives in No.1 Hospital Affiliated to Zhongshan Univ.
The patients with hilar cholangiocarcinoma 84 of radical surgery treatment, enters group a, work similar with exclusion standard with training set
For checking collection II (External validation).
Under the conditions of the approval for participating in hospital's Institutional Review Board is obtained, the correlation that inventor collects and arranged
The relevant information of group of participants, and obtain the informed consent of participant.
1.2 essential informations are collected
For each participation patient, inventor is collected using questionnaire and arranges its basic characteristics of human body's information.
Medical diagnosis on disease record and clinical detection of the clinical diagnosis information from patient, pathological examination record.Therapeutic scheme
Perform the operation and note down from patient, and patient disease history and operation plan are carefully revalued by related doctor.
Patient's prognosis information from east hospital of liver and gall surgical department from January, 2001 in June, 2014 carry out follow-up and
Examination (follow-up is carried out once every half a year), the follow-up information of No.1 Hospital Affiliated to Zhongshan Univ. was from 2008 1
Month follow-up is in September, 2015.Follow-up information includes patient's transfer, recurrence, death etc., takes phone and letter
Part follow-up.
1.3 hilar cholangiocarcinoma traditional clinical Staging Systems
For each patients with hilar cholangiocarcinoma, inventor has carried out qualitative, including AJCC to its clinical analysis
The 7th edition TNM stage, Bismuth-Corlette, MSKCC, Gazzaniga and Mayo Clinic by stages.
1.4 statistical modelings and verification method
The prognostic indicator for the patients with hilar cholangiocarcinoma mainly investigated is overall survival phase, is defined as date of surgery
To the time between date of death.Examined first with Kaplan-Meier figures and log-rank and investigate patient
Relation between body characteristicses and Overall survival, and being investigated using polynary COX ratios regression model influences patient total
The independent risk factor of life cycle.In training set, continuous variable is that patient CA19-9 is carried out by inventor
Trisection, and compare relative risk of the higher level group relative to low-level group.At the same time, the present inventor
The correlation between age and the life cycle of patient has also been investigated, it is found that the age is presented notable with total survival risk
Inverted U association, therefore the age is investigated according to non-linear relation.
Based on multivariate regression models result, inventor have selected for prognosis prediction using Gradual regression analysis model
Optimal statistical model, and utilization Akaike information criterion (AIC) parameter has investigated the effect of model
Energy.Further investigated accuracy of the model again in prognosis prediction using C- parameters, and using 1000 times from
Lift sampling and simplation verification is carried out to model.In order to which relatively more different models by stages are in tumour patient prognosis prediction
Accuracy, the C- parameter values of inventor's on the one hand more different models simultaneously utilize time dependent ROC models
Area under model prediction accuracy and sensitivity curves to compare different time points.All systems in the present invention
Meter process is to use R software analysis, and significant difference is set as P<0.05.
2. data result
2.1 training sets find to significantly affect the key factor of patients with hilar cholangiocarcinoma prognosis
Using the training set sample of east hospital of liver and gall surgical department, inventor by statistical analysis find patient age,
Lymph node invade state, preoperative CA19-9, portal vein invade, arteria hepatica invade and postoperative rim condition and
Patient's prognosis is significantly correlated (table 1).
Table 1：Multifactor COX ratios regression model find age, postoperative Positive margin, portal vein invade state,
It is that influence hilar cholangiocarcinoma is suffered from that arteria hepatica, which invades state, lymph node status and preoperative CA19-9 levels,
The independent factor of person's prognosis
Calculated by statistical model, the present inventor constructs influence hilar cholangiocarcinoma using above-mentioned risk factors
The alignment table model (Fig. 1) of patient.The application method of the list is：First behavior difference risks and assumptions exist
Fraction during different grouping, according to individual patients age, lymphatic metastasis, surgical outcome, CA19-9, door
Risk score sum corresponding to the index of correlation such as vein infringement and arteria hepatica infringement correspond to overall score row,
Vertical line is drawn downwards according to overall risk fraction can obtain patient 3 years and the survival rate value of 5 years.
The present invention demonstrates forecasting accuracy of the prognostic predictive model in training set, finds prediction and observes
3 years of the patients with hilar cholangiocarcinoma arrived and 5 years overall survival ratios it is more consistent, C values be 0.68 (95%CI
=0.61-0.71；Fig. 2).
Advantage of the alignment table relative to conventional model in 2.2 present invention
Compare it is of the invention in the value of the prognostic predictive model and Classical forecast model that build in prognosis prediction
Found with difference, the prognosis prediction risk model constructed by the present invention is significantly better than AJCC the 7th edition TNM
By stages, Bismuth-Corlette, MSKCC, Gazzaniga and Mayo Clinic is by stages (Fig. 3).
2.3 checkings (Internal Validation) of the patient to alignment table prognosis prediction originated with hospital
We utilize the 93 clinical characteristic data and prognosis number also from east hospital of liver and gall surgical department
According to being analyzed it and being verified, it is found that the alignment table can preferably predict 3 years survival rates of patient, C values
For 0.65 (95%CI=0.56-0.74；Fig. 4), compared with traditional Staging System, the value-at-risk can be more
The survival region (Fig. 5) of good prediction patients with hilar cholangiocarcinoma.
Checking (External Validation) of the patient in 2.4 Different hospitals source to alignment table prognosis prediction
We are using 84 clinical characteristic data also from affiliated hospital of Zhongshan University first and in advance
Data are analyzed and verified to it afterwards, it is again seen that the alignment table can preferably predict patient's existence in 3 years
Rate, C values are 0.68 (95%CI=0.61-0.75；Fig. 6), compared with traditional Staging System, the risk
Value can preferably predict the survival region (Fig. 7) of patients with hilar cholangiocarcinoma.
Summarize：In summary, the present invention is carried out in advance using training set design is a set of to hilar cholangiocarcinoma prognosis
The alignment table of survey predicts that the Risk Forecast System is relative to tradition for patient's survival region of 3 years and 5 years
Staging System more accurately can be predicted to the mortality risk of patient, with clinical value.
Embodiment 2
Fig. 1 alignment table equal proportion is amplified, and printed to using common printer on A4 paper, you can
Obtain the card of the present embodiment.
Embodiment 3
Fig. 1 alignment table equal proportion is amplified, A4 paper sizes are printed to using conventional printing machine
On PVC thin slices, you can obtain the card of plastic material.
Claims (10)
1. a kind of carrier that Postoperative determination is carried out for patients with hilar cholangiocarcinoma, the carrier is used to calculate
The fraction and patient 3 years survival rate Y3 and/or 5 years survival rate Y5 of risks and assumptions；Wherein, risks and assumptions are extremely
Include patient age X less；
Wherein, the fraction of patient age is calculated as below：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；With
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
3 years survival rates are calculated as below：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；With
Overall score Z>173.5, then 3 years survival rate Y3<5%；
5 years survival rates are calculated as below：
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；With
Overall score Z>134 points, then 5 years survival rate Y5<5%；
Wherein, overall score Z is the fraction sum of each risks and assumptions.
2. carrier as claimed in claim 1, it is characterised in that the risks and assumptions also include lymph node
Transfer, surgical outcome, the CA19-9 levels calculated with U/ml, portal vein are invaded and arteria hepatica infringement.
3. carrier as claimed in claim 2, it is characterised in that the lymphatic metastasis, surgical outcome,
The fraction that CA19-9 levels, portal vein are invaded and arteria hepatica is invaded is calculated as below：
(a) lymphatic metastasis：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(b) surgical outcome：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(c) CA19-9 levels：
0-73.5U/ml, 0 point；
It is less than or equal to 325.0U/ml, 31.2 points more than 73.5；
More than 325.0U/ml, 50.0 points；
(d) portal vein is invaded：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(e) arteria hepatica is invaded：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points.
4. the carrier as any one of claim 1-3, it is characterised in that the carrier is printing
Product, such as card.
5. carrier as claimed in claim 4, it is characterised in that the printed matter includes alignment table, institute
Stating alignment table includes fraction row, risks and assumptions row, overall score row and 3 years survival rate rows and/or life in 5 years
Rate row is deposited, wherein, the risks and assumptions row at least includes the age row with fraction row side by side, the life in 3 years
Deposit rate row and/or 5 years survival rate rows and the overall score row side by side,
Wherein, the arrangement of fraction row and age row meets following relation：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；With
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
Arrangement between 3 years survival rate rows and overall score row meets following relation：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；With
Overall score Z>173.5, then 3 years survival rate Y3<5%；
Arrangement between 5 years survival rate rows and overall score row meets following relation：
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；With
Overall score Z>134 points, then 5 years survival rate Y5<5%.
6. carrier as claimed in claim 5, it is characterised in that also include following on the printed matter
Meaning one or more or full content：
(a) lymphatic metastasis：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(b) surgical outcome：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(c) CA19-9 levels：
0-73.5U/ml, 0 point；
It is less than or equal to 325.0U/ml, 31.2 points more than 73.5；
More than 325.0U/ml, 50.0 points；
(d) portal vein is invaded：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(e) arteria hepatica is invaded：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points；
Wherein, content (a)-(e) is provided in the way of word description on the printed matter, and/
Or graphically provide in the alignment table, for example, the alignment table is also included with fraction row side by side
Lymphatic metastasis row, surgical outcome row, CA19-9 horizontal lines, portal vein invade row and arteria hepatica invade row
In at least one of, it is any multinomial or whole.
7. the carrier as any one of claim 1-3, it is characterised in that the carrier is information
Processing equipment, including memory and processor, wherein, the processor is configured to carry out following functions：
(I) fraction of each risks and assumptions is calculated according to following relation：
(1) age score：
Age X is less than or equal to 25 years old, and fraction is 0；
Age X is between 25 years old to 57.5 years old, fraction=2.982 × (X-25)；
Age X was more than or equal to 57.5 years old and less than 85 years old, fraction=- 2.016 × X+100.9；
Age X is more than or equal to 85 years old, and fraction is 28.8 points；
(2) lymphatic metastasis fraction：
Without lymphatic metastasis, 0 point；
There are lymphatic metastasis, 24.5 points；
(3) surgical outcome fraction：
Cut off as R0,0 point；
Cut off as R1 or R2,24.0 points；
(4) preoperative CA19-9 horizontal scores：
0-73.5U/ml, 0 point；
More than 73.5 and less than or equal to 325.0U/ml, 31.2 points；
More than 325.0U/ml, 50.0 points；
(5) portal vein invades fraction：
Without infringement or only branch's infringement, 0 point；
There are trunk infringement, 100 points；With
(6) arteria hepatica invades fraction：
Without infringement, 0 point；
Branch invades, 27.5 points；
Trunk is invaded, 77.5 points；
(II) the whole fractions summation obtained to (I), calculating obtains overall score Z；With
(III) 3 years survival rates (Y3) of patient or 5 years survival rates (Y5) are calculated according to following relation：
Overall score Z≤20 point, then 3 years survival rate Y3 >=80%；
20<Overall score Z≤48.5 point, then 3 years survival rate Y3=0.872-Z/285；
48.5<Overall score Z≤68.5 point, then 3 years survival rate Y3=0.943-Z/200；
68.5<Overall score Z≤158.5 point, then 3 years survival rate Y3=0.981-Z/180；
158.5<Overall score Z≤173.5 point, then 3 years survival rate Y3=0.628-Z/300；
Overall score Z>173.5, then 3 years survival rate Y3<5%；
Overall score Z≤8 point, then 5 years survival rate Y5 >=70%；
8<Overall score Z≤30 point, then 5 years survival rate Y5=0.736-Z/220；
30<Overall score Z≤97 point, then 5 years survival rate Y5=0.779-Z/167.5；
97<Overall score Z≤117 point, then 5 years survival rate Y5=0.685-Z/200；
117<Overall score Z≤134 point, then 5 years survival rate Y5=0.444-Z/340；
Overall score Z>134 points, then 5 years survival rate Y5<5%.
8. carrier as claimed in claim 7, it is characterised in that described information processing equipment also includes defeated
Enter device, display device and identifying device.
9. a kind of kit for patients with hilar cholangiocarcinoma prognosis, the kit includes CA19-9 inspection
Test agent, the carrier any one of claim 1-7, and optional service manual.
10.CA19-9 detection reagents are in the kit of Postoperative determination of patients with hilar cholangiocarcinoma is prepared
Using, wherein, the kit also contains the carrier any one of claim 1-7 and optional
Service manual.
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