Nakamura Masaki, Iwahashi Makoto, Nakamori Mikihito, Ojima Toshiyasu, Katsuda Masahiro, Iida Takeshi, Hayata Keiji, Kato Tomoya, Yamaue Hiroki
Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan.
Surg Today. 2014 May;44(5):875-83. doi: 10.1007/s00595-013-0628-z. Epub 2013 Jun 20.
Recent studies have shown that the modified Glasgow Prognostic Score (mGPS), which is an inflammation-based prognostic score, is useful as a prognostic index for some cancer cases. The purpose of this study was to create a prognostic scoring system for patients with esophageal squamous cell carcinoma (ESCC) that was more independent and sensitive than the mGPS.
One hundred sixty-eight patients who had undergone esophagectomy for ESCC were included in the study. The new mGPS (NmGPS) was calculated based on the following cutoff values: CRP >0.75 mg/dL indicated NmGPS 1 or 2, depending on the absence or presence of hypoalbuminemia (<3.5 g/dL); and CRP ≤0.75 mg/dL indicated NmGPS 0. We also performed an analysis based on cutoff values of 0.5 and 0.25 mg/dL for CRP.
Only the NmGPS with a cutoff CRP value of 0.5 mg/dL was able to divide into three independent patient groups in the survival curves. In the multivariate analyses, a NmGPS (CRP cutoff; 0.5 mg/dL) of 2 was a more significant independent prognostic factor (HR 4.437, 95 % CI 2.000-9.844, p = 0.0002) than a mGPS of 2 (HR 2.726, 95 % CI 1.021-7.112, p = 0.0449).
The new prognostic score NmGPS (CRP cutoff; 0.5 mg/dL) was more independent and sensitive than the mGPS for patients with ESCC.
近期研究表明,改良格拉斯哥预后评分(mGPS)作为一种基于炎症的预后评分,对某些癌症病例而言是有用的预后指标。本研究的目的是为食管鳞状细胞癌(ESCC)患者创建一种比mGPS更具独立性和敏感性的预后评分系统。
本研究纳入了168例行ESCC食管切除术的患者。新的mGPS(NmGPS)根据以下临界值计算:CRP>0.75mg/dL表明NmGPS为1或2,具体取决于是否存在低白蛋白血症(<3.5g/dL);CRP≤0.75mg/dL表明NmGPS为0。我们还基于CRP的临界值0.5和0.25mg/dL进行了分析。
只有临界CRP值为0.5mg/dL的NmGPS能够在生存曲线中分为三个独立的患者组。在多变量分析中,临界值为0.5mg/dL的NmGPS为2是比mGPS为2更显著的独立预后因素(HR 4.437,95%CI 2.000 - 9.844,p = 0.0002),而mGPS为2时(HR 2.726,95%CI 1.021 - 7.112,p = 0.0449)。
对于ESCC患者,新的预后评分NmGPS(临界CRP值;0.5mg/dL)比mGPS更具独立性和敏感性。