Ishizuka Mitsuru, Kita Junji, Shimoda Mitsugi, Rokkaku Kyu, Kato Masato, Sawada Tokihiko, Kubota Keiichi
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
J Surg Oncol. 2009 Jul 1;100(1):38-42. doi: 10.1002/jso.21294.
Few studies have investigated the Glasgow Prognostic Score (GPS) in patients with liver metastases from colorectal cancer (LM-CRC).
The GPS was calculated as follows: patients with both an elevated level of CRP (>10 mg/L) and hypoalbuminemia (Alb <35 g/L) were allocated a score of 2, and patients showing one or neither of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively.
Ninety-three patients were evaluated retrospectively. Kaplan-Meier analysis and log rank test revealed that a higher GPS predicted a higher postoperative death (P < 0.0001). Univariate analysis revealed that sex, number of hepatectomy, number of tumors, synchronous lung metastasis and CRP were associated with postoperative death. Multivariate analysis revealed that number of hepatectomy (odds ratio, 3.193; 95% CI, 1.093-9.330; P = 0.0338), number of tumors (odds ratio, 2.946; 95% CI, 1.094-7.931; P = 0.0325), synchronous lung metastasis (odds ratio, 3.424; 95% CI, 1.055-11.11; P = 0.0404) and CRP (odds ratio, 4.509; 95% CI, 1.313-15.49; P = 0.0167) were associated with postoperative death.
GPS is able to classify patients with LM-CRC into three independent groups. Among the selected factors, CRP is considered an important and high sensitive predictor of postoperative death in such patients.
很少有研究调查结直肠癌肝转移(LM-CRC)患者的格拉斯哥预后评分(GPS)。
GPS的计算方法如下:C反应蛋白(CRP)水平升高(>10mg/L)且伴有低白蛋白血症(Alb<35g/L)的患者评分为2分,仅出现其中一项或两项血液化学异常均未出现的患者分别评分为1分或0分。
对93例患者进行回顾性评估。Kaplan-Meier分析和对数秩检验显示,较高的GPS预示着术后死亡风险更高(P<0.0001)。单因素分析显示,性别、肝切除数量、肿瘤数量、同步性肺转移和CRP与术后死亡相关。多因素分析显示,肝切除数量(比值比,3.193;95%可信区间,1.093-9.330;P=0.0338)、肿瘤数量(比值比,2.�46;95%可信区间,1.094-7.931;P=0.0325)、同步性肺转移(比值比,3.424;95%可信区间,1.055-11.11;P=0.0404)和CRP(比值比,4.509;95%可信区间,1.313-15.49;P=0.0167)与术后死亡相关。
GPS能够将LM-CRC患者分为三个独立的组。在所选择的因素中,CRP被认为是此类患者术后死亡的一个重要且高敏感性的预测指标。