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食管鳞状细胞癌患者生存的新预后评分

New prognostic score for the survival of patients with esophageal squamous cell carcinoma.

作者信息

Nakamura Masaki, Iwahashi Makoto, Nakamori Mikihito, Ojima Toshiyasu, Katsuda Masahiro, Iida Takeshi, Hayata Keiji, Kato Tomoya, Yamaue Hiroki

机构信息

Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan.

出版信息

Surg Today. 2014 May;44(5):875-83. doi: 10.1007/s00595-013-0628-z. Epub 2013 Jun 20.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

The new prognostic score NmGPS (CRP cutoff; 0.5 mg/dL) was more independent and sensitive than the mGPS for patients with ESCC.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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