Tai Caroline G, Johnson Timothy V, Abbasi Ammara, Herrell Lindsey, Harris Wayne B, Kucuk Omer, Canter Daniel J, Ogan Kenneth, Pattaras John G, Nieh Peter T, Master Viraj A
Department of Urology, Emory University, Atlanta, Georgia, USA.
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Indian J Urol. 2014 Jan;30(1):33-7. doi: 10.4103/0970-1591.124203.
The modified Glasgow prognostic Score (mGPS) incorporates C-reactive protein and albumin as a clinically useful marker of tumor behavior. The ability of the mGPS to predict metastasis in localized renal cell carcinoma (RCC) remains unknown in an external validation cohort.
Patients with clinically localized clear cell RCC were followed for 1 year post-operatively. Metastases were identified radiologically. Patients were categorized by mGPS score as low-risk (mGPS = 0 points), intermediate-risk (mGPS = 1 point) and high-risk (mGPS = 2 points). Univariate, Kaplan-Meier and multivariate Cox regression analyses examined Recurrence -free survival (RFS) across patient and disease characteristics.
Of the 129 patients in this study, 23.3% developed metastases. Of low, intermediate and high risk patients, 10.1%, 38.9% and 89.9% recurred during the study. After accounting for various patient and tumor characteristics in multivariate analysis including stage and grade, only mGPS was significantly associated with RFS. Compared with low-risk patients, intermediate- and high-risk patients experienced a 4-fold (hazard ratios [HR]: 4.035, 95% confidence interval [CI]: 1.312-12.415, P = 0.015) and 7-fold (HR: 7.012, 95% CI: 2.126-23.123 P < 0.001) risk of metastasis, respectively.
mGPS is a robust predictor of metastasis following potentially curative nephrectomy for localized RCC. Clinicians may consider mGPS as an adjunct to identify high-risk patients for possible enrollment into clinical trials or for patient counseling.
改良格拉斯哥预后评分（mGPS）纳入了C反应蛋白和白蛋白，作为肿瘤行为的一种临床有用标志物。在外部验证队列中，mGPS预测局限性肾细胞癌（RCC）转移的能力尚不清楚。
对临床局限性透明细胞RCC患者术后进行1年随访。通过影像学检查确定转移情况。根据mGPS评分将患者分为低风险（mGPS = 0分）、中风险（mGPS = 1分）和高风险（mGPS = 2分）。单因素、Kaplan-Meier和多因素Cox回归分析研究了患者和疾病特征的无复发生存期（RFS）。
本研究的129例患者中，23.3%发生转移。在低、中、高风险患者中，分别有10.1%、38.9%和89.9%在研究期间复发。在多因素分析中考虑了包括分期和分级在内的各种患者和肿瘤特征后，只有mGPS与RFS显著相关。与低风险患者相比，中风险和高风险患者发生转移的风险分别为4倍（风险比[HR]：4.035，95%置信区间[CI]：1.312 - 12.415，P = 0.015）和7倍（HR：7.012，95% CI：2.126 - 23.123，P < 0.001）。
mGPS是局限性RCC根治性肾切除术后转移的有力预测指标。临床医生可考虑将mGPS作为一种辅助手段，以识别可能符合入组临床试验条件或需要进行患者咨询的高风险患者。
