Jiang Ai-Gui, Chen Hong-Lin, Lu Hui-Yu
Department of Respiratory Diseases, Taizhou People's Hospital, 210 Yingchun Road, Taizhou, 225300, Jiangsu Province, People's Republic of China,
J Cancer Res Clin Oncol. 2015 Mar;141(3):563-8. doi: 10.1007/s00432-014-1839-4. Epub 2014 Sep 26.
Previous studies have shown that Glasgow prognostic score (GPS) and prognostic index (PI) are also powerful prognostic tool for patients with advanced non-small cell lung cancer (NSCLC). The aim of this study was to compare the prognostic value between GPS and PI.
We enrolled consecutive patients with advanced NSCLC in this prospective cohort. GPS and PI were calculated before the onset of chemotherapy. The prognosis outcomes included 1-, 3-, and 5-year progression-free survival and overall survival (OS). The performance of two scores in predicting prognosis was analyzed regarding discrimination and calibration.
138 patients were included in the study. The area under the receiver operating characteristic curve for GPS predicting 1-year DFS was 0.62 (95 % confidence interval (CI) 0.56-0.68, P < 0.05), and the area under curve for PI predicting 1-year DFS was 0.57 (95 % CI 0.52-0.63). Delong's test showed that GPS was more accurate than PI in predicting 1-year DFS (P < 0.05). Similar results of discriminatory power were found for predicting 3-year DFS, 1-year OS, and 3-year OS. The predicted 1-year DFS by GPS 0, GPS 1, and GPS 2 were 62.5, 42.1, and 23.1 %, respectively, while actual 1-year DFS by GPS 0, GPS 1, and GPS 2 were 61.1, 43.8, and 27.2 %, respectively. Calibration of the Hosmer and Lemeshow statistic showed good fit of the predicted 1-year DFS to the actual 1-year DFS by GPS (χ(2) = 4.326, P = 0.462), while no fit was found between the predicted 1-year DFS and the actual 1-year DFS by PI (χ(2) = 15.234, P = 0.091). Similar results of calibration power were found for predicting 3-year DFS, 5-year DFS, 1-year OS, 3-year OS, and 5-year OS by GPS and PI.
GPS is more accurate than PI in predicting prognosis for patients with advanced NSCLC. GPS can be used as a useful and simple tool for predicting prognosis in patients with NSCLC. However, GPS only can be used for preliminary assessment because of low predicting accuracy.
既往研究表明，格拉斯哥预后评分（GPS）和预后指数（PI）也是晚期非小细胞肺癌（NSCLC）患者强有力的预后工具。本研究旨在比较GPS和PI的预后价值。
我们在这个前瞻性队列中纳入了连续的晚期NSCLC患者。在化疗开始前计算GPS和PI。预后结果包括1年、3年和5年无进展生存期及总生存期（OS）。从区分度和校准度方面分析了两个评分在预测预后中的表现。
本研究共纳入138例患者。GPS预测1年无病生存期（DFS）的受试者工作特征曲线下面积为0.62（95%置信区间（CI）0.56 - 0.68，P < 0.05），PI预测1年DFS的曲线下面积为0.57（95% CI 0.52 - 0.63）。德龙检验显示，在预测1年DFS方面，GPS比PI更准确（P < 0.05）。在预测3年DFS、1年OS和3年OS方面也发现了类似的区分度结果。GPS为0、GPS为1和GPS为2时预测的1年DFS分别为62.5%、42.1%和23.1%，而GPS为0、GPS为1和GPS为2时实际的1年DFS分别为61.1%、43.8%和27.2%。霍斯默和莱梅肖统计量的校准显示，GPS预测的1年DFS与实际的1年DFS拟合良好（χ(2) = 4.326，P = 0.462），而PI预测的1年DFS与实际的1年DFS之间未发现拟合（χ(2) = 15.234，P = 0.091）。在预测3年DFS、5年DFS、1年OS、3年OS和5年OS方面，GPS和PI的校准能力也有类似结果。
在预测晚期NSCLC患者的预后方面，GPS比PI更准确。GPS可作为预测NSCLC患者预后的一种有用且简单的工具。然而，由于预测准确性较低，GPS仅可用于初步评估。
