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晚期卵巢癌患者基于炎症的预后评分评估

Evaluation of an inflammation-based prognostic score in patients with advanced ovarian cancer.

作者信息

Sharma Rohini, Hook Jane, Kumar Munish, Gabra Hani

机构信息

Department of Medicine, University of Sydney, Sydney, NSW, Australia.

出版信息

Eur J Cancer. 2008 Jan;44(2):251-6. doi: 10.1016/j.ejca.2007.11.011. Epub 2007 Dec 26.

Abstract

BACKGROUND

There is increasing evidence that the presence of an ongoing systemic inflammatory response is associated with poor outcome in patients with advanced cancer. The aim of this study was to validate whether an inflammation-based prognostic score (Glasgow Prognostic Score, GPS) is associated with survival in patients with advanced stage (stage III/IV) ovarian cancer.

PATIENTS AND METHODS

An audit was conducted of patients with a new diagnosis of stage III or IV ovarian cancer presenting to the West London Gynae-Oncology Centre between October 2003 and June 2006 (n=154). The GPS was constructed as follows: Patients with both an elevated C-reactive protein (>10 mg/l) and hypoalbuminaemia (<35 g/l) were allocated a score of 2. Patients in whom only one or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively.

RESULTS

On univariate analysis GPS, histological type, ALP, performance status, primary surgery and ascites were predictors of overall survival. On multivariate a high GPS score, non-serous histology, high ALP and no initial surgery were independent predictors of worse overall survival in this population.

CONCLUSIONS

The presence of a systemic inflammatory response, as measured by the GPS, is an independent predictor of poor overall survival in patients with advanced ovarian cancer independent of treatment received.

摘要

背景

越来越多的证据表明,持续的全身炎症反应与晚期癌症患者的不良预后相关。本研究的目的是验证基于炎症的预后评分(格拉斯哥预后评分,GPS)是否与晚期(III/IV期)卵巢癌患者的生存相关。

患者与方法

对2003年10月至2006年6月期间在西伦敦妇科肿瘤中心新诊断为III期或IV期卵巢癌的患者进行了一项审计(n = 154)。GPS的构建如下:C反应蛋白升高(>10 mg/l)且白蛋白血症(<35 g/l)的患者得分为2分。仅存在其中一种生化异常或不存在生化异常的患者分别得分为1分或0分。

结果

单因素分析显示,GPS、组织学类型、碱性磷酸酶、体能状态、初次手术和腹水是总生存的预测因素。多因素分析显示,高GPS评分、非浆液性组织学、高碱性磷酸酶和未进行初次手术是该人群总生存较差的独立预测因素。

结论

通过GPS测量的全身炎症反应的存在是晚期卵巢癌患者总生存较差的独立预测因素,与所接受的治疗无关。

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