Qayyum T, McArdle P A, Lamb G W, Going J J, Orange C, Seywright M, Horgan P G, Oades G, Aitchison M A, Edwards J
Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, UK.
Urol Int. 2012;88(3):277-81. doi: 10.1159/000334971. Epub 2012 Feb 23.
The local and systemic inflammatory responses provide prognostic information in cancer. The modified Glasgow Prognostic Score (mGPS) provides additional prognostic information than C-reactive protein (CRP) alone when assessing the systemic inflammation in cancer. The aim of this study was to determine the role of local and systemic inflammation in renal cancer.
The cohort consisted of 79 patients who had undergone potential curative resection. Systemic inflammation, mGPS, was constructed by measuring preoperative CRP and albumin concentrations and the Klintrup-Makinen score was evaluated histologically for the local inflammatory response. Pathological parameters such as T stage, grade and tumour necrosis were also assessed. The local inflammatory response was assessed by examining all inflammatory cells at the tumour edge on diagnostic haematoxylin and eosin slides.
On univariate analysis, T stage (p < 0.001), grade (p = 0.044) and mGPS (p < 0.001) were significant predictors of cancer-specific survival. On multivariate analysis, mGPS (hazard ratio 8.64, 95% confidence interval 3.5-21.29, p < 0.001) was the only significant independent predictor of cancer-specific survival.
A preoperative systemic inflammatory response as measured by the mGPS is an independent predictor of poor cancer-specific survival in renal cancer in patients undergoing potential curative resection.
局部和全身炎症反应可为癌症提供预后信息。改良格拉斯哥预后评分（mGPS）在评估癌症全身炎症时，比单独的C反应蛋白（CRP）能提供更多预后信息。本研究的目的是确定局部和全身炎症在肾癌中的作用。
该队列包括79例接受了潜在根治性切除术的患者。通过测量术前CRP和白蛋白浓度构建全身炎症指标mGPS，并通过组织学评估克林特鲁普-马基宁评分以评估局部炎症反应。还评估了诸如T分期、分级和肿瘤坏死等病理参数。通过在诊断性苏木精和伊红染色切片上检查肿瘤边缘的所有炎症细胞来评估局部炎症反应。
单因素分析显示，T分期（p < 0.001）、分级（p = 0.044）和mGPS（p < 0.001）是癌症特异性生存的显著预测因素。多因素分析显示，mGPS（风险比8.64，95%置信区间3.5 - 21.29，p < 0.001）是癌症特异性生存的唯一显著独立预测因素。
对于接受潜在根治性切除术的肾癌患者，术前通过mGPS测量的全身炎症反应是癌症特异性生存不良的独立预测因素。
