Li Qing-Qing, Lu Zhi-Hao, Yang Li, Lu Ming, Zhang Xiao-Tian, Li Jian, Zhou Jun, Wang Xi-Cheng, Gong Ji-Fang, Gao Jing, Li Jie, Li Yan, Shen Lin
Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, China E-mail :
Asian Pac J Cancer Prev. 2014;15(2):945-50. doi: 10.7314/apjcp.2014.15.2.945.
To explore the value of systemic inflammatory markers as independent prognostic factors and the extent these markers improve prognostic classification for patients with inoperable advanced or metastatic gastric cancer (GC) receiving palliative chemotherapy.
We studied the prognostic value of systemic inflammatory factors such as circulating white blood cell count and its components as well as that combined to form inflammation-based prognostic scores (Glasgow Prognostic Score (GPS), Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI) and Prognostic Nutritional Index (PNI)) in 384 patients with inoperable advanced or metastatic gastric cancer (GC) receiving first-line chemotherapy. Univariate and multivariate analyses were performed to examine the impact of inflammatory markers on overall survival (OS).
Univariate analysis revealed that an elevated white blood cell, neutrophil and/or platelet count, a decreased lymphocyte count, a low serum albumin concentration, and high CRP concentration, as well as elevated NLR/PLR , GPS, PI, PNI were significant predictors of shorter OS. Multivariate analysis demonstrated that only elevated neutrophil count (HR 3.696, p=0.003) and higher GPS (HR 1.621, p=0.01) were independent predictors of poor OS.
This study demonstrated elevated pretreatment neutrophil count and high GPS to be independent predictors of shorter OS in inoperable advanced or metastatic GC patients treated with first-line chemotherapy. Upon validation of these data in independent studies, stratification of patients using these markers in future clinical trials is recommended.
探讨全身炎症标志物作为独立预后因素的价值，以及这些标志物对接受姑息化疗的不可切除的晚期或转移性胃癌（GC）患者预后分类的改善程度。
我们研究了全身炎症因子的预后价值，如循环白细胞计数及其组分，以及将它们组合形成的基于炎症的预后评分（格拉斯哥预后评分（GPS）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、预后指数（PI）和预后营养指数（PNI）），研究对象为384例接受一线化疗的不可切除的晚期或转移性胃癌（GC）患者。进行单因素和多因素分析以检验炎症标志物对总生存期（OS）的影响。
单因素分析显示，白细胞、中性粒细胞和/或血小板计数升高，淋巴细胞计数降低，血清白蛋白浓度低，CRP浓度高，以及NLR/PLR、GPS、PI、PNI升高是OS较短的显著预测因素。多因素分析表明，只有中性粒细胞计数升高（HR 3.696，p = 0.003）和较高的GPS（HR 1.621，p = 0.01）是OS较差的独立预测因素。
本研究表明，在接受一线化疗的不可切除的晚期或转移性GC患者中，治疗前中性粒细胞计数升高和高GPS是OS较短的独立预测因素。在独立研究中验证这些数据后，建议在未来的临床试验中使用这些标志物对患者进行分层。
