Objective:To study the correlation between systemic immune inflammation index (SII) and prognosis of patients with hilar cholangiocarcinoma after surgical treatment.Methods:The clinical data of 181 patients with hilar cholangiocarcinoma treated by surgery at the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2016 were retrospectively analyzed. There were 119 men and 62 women, with an average age of 62.4 years. SII was calculated using preoperative routine blood tests. Receiver operating characteristic (ROC) curve was used to obtain the optimal cutoff value of SII. The Kaplan-Meier method was used to draw survival curves and survival rates were compared by log-rank test. The Cox proportional risk model was used to analyze single and multiple factors.Results:The SII area under the ROC curve in predicting postoperative survival was 0.749(95% CI: 0.641-0.858), the optimal threshold was 412.6. Using this threshold, patients were divided into the low SII group (SII≤412.6, n=80) and the high SII group (SII>412.6, n=101). The 1, 3, and 5-year cumulative survival rates of patients in the low SII group were 87.5%, 57.5%, and 26.3%, which were significantly better than those of the high SII group of 71.3%, 39.6%, and 9.9% respectively ( P<0.05). Multivariate analysis showed that SII>412.6 ( HR=2.887, 95% CI: 2.256-7.903, P<0.05) was an independent risk factor for overall survival of patients with hilar cholangiocarcinoma. Conclusion:Preoperative SII had predictive values for postoperative survival of patients with hilar cholangiocarcinoma, SII>412.6 was an independent risk factor for postoperative survival.

Objective:To analyze the clinical and imaging features, and treatment and curative effects of primary splenic angiosarcoma.Methods:A retrospective study was conducted on 6 patients with primary splenic angiosarcoma diagnosed histopathologically at the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2019. The clinical characteristics, CT and ultrasound imaging findings, treatment methods and survival outcomes of these patients were analyzed.Results:There were 4 males and 2 females, with an average age of 52.6 years. These 6 patients with primary splenic angiosarcoma had no specific clinical manifestations, and the diagnoses were all confirmed histopathologically after surgery. CT examination of these 6 patients showed that the spleen volume was increased, with splenic space-occupying lesions. The lesions were single in 1 patient and multiple in 5 patients. Some lesions fused with each other. There were multiple intrahepatic metastases in 1 patient. Ultrasound in 3 patients showed enlarged solid hypoechoic spleens, and rich blood flow at the edges. Five patients underwent splenectomy with complete removal of tumors. For the patient with multiple lesions in the spleen and multiple space-occupying lesions in the liver who could not be treated radically, only splenectomy was done. This patient developed significantly more liver lesions 2 months after surgery, and survived for 3 months. Two patients who underwent postoperative adjuvant chemotherapy relapsed at 9 months and 13 months after surgery. They survived for 16 months and 19 months, respectively. A patient who received postoperative adjuvant chemotherapy survived for 27 months without any obvious signs of recurrence. A patient who underwent targeted therapy relapsed after 10 months, and survived for 14 months after surgery. The remaining patient who underwent simple surgery relapsed 4 months after surgery and died 6 months later.Conclusions:Primary splenic angiosarcoma is a highly malignant tumor. In this study, it lacked specific clinical manifestations and imaging features and its diagnosis required histopathological examination. Surgical resection is the main treatment for this disease. Whether surgery combined with postoperative adjuvant therapy is a more effective treatment than surgery alone for splenic angiosarcoma requires more studies in the future to determine.

Objective: To investigate the clinical characteristics, treatment and curative effect of primary hepatic angiosarcoma. Methods: A retrospective study was conducted on 10 patients with primary hepatic angiosarcoma who were treated in the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University from April 2012 to July 2018. There were 6 males and 4 females, with an average age of 55.1 (range 39.0 to 71.0) years. The clinical features, imaging findings, treatment methods and survival time of the patients were analyzed. Results: The clinical manifestations of 10 patients with primary hepatic angiosarcoma were non-specific and all were confirmed by pathology. Three cases had diffuse liver echo changes on ultrasound, and 7 cases had hypoechoic lesions with blurred borders. Space occupying lesions were found in 10 cases by CT. A total of five patients underwent partial hepatectomy, 1 case received chemotherapy, 1 case received transcatheter arterial chemoembolization (TACE), 2 case received molecular targeted therapy, and 1 case was untreated. From diagnosis to the last follow-up, the survival time of the 5 patients receiving surgical resection were 9 months, 15 months, 19 months, 21 months and 26 months. The survival time of the patient receiving chemotherapy was 7 months. The survival time of the patient receiving TACE was 3 months. Two patients were targeted for treatment, one survived for 32 months, another had been targeted for 15 months, and treatment was continuing. One patient survived for 1 month without treatment. Conclusions Primary hepatic angiosarcoma has a high degree of malignancy and a poor prognosis. No specific clinical manifestations and imaging findings, confirmed by pathological examination. Patients with partial hepatectomy have a better survival. Targeted therapy may be the most effective treatment for primary hepatic angiosarcoma in the future.