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肝切除术前联合评估格拉斯哥预后评分和癌胚抗原浓度可预测结直肠癌肝转移患者的术后结局。

Combined evaluation of the Glasgow prognostic score and carcinoembryonic antigen concentration prior to hepatectomy predicts postoperative outcomes in patients with liver metastasis from colorectal cancer.

作者信息

Kobayashi Takashi, Kawakamil Masayo, Hara Yoshiaki, Shioiri Sadaaki, Yasuno Masamichi, Teruya Masanori, Kaminishi Michio

出版信息

Hepatogastroenterology. 2014 Jul-Aug;61(133):1359-62.

Abstract

BACKGROUND/AIMS: Little is known about the ability of the inflammation-based Glasgow prognostic score (GPS).

METHODOLOGY

106 patients who underwent curative resection for colorectal liver metastasis (CRLM) were analyzed. Patients with an elevated Creactive protein concentration (>10 mg/L) and hypoalbuminemia (<35 g/L) at admission were assigned a GPS 2, those with only 1 of these biochemical abnormalities were assigned a GPS 1, and those without either abnormality were assigned a GPS 0.

RESULTS

Multivariate analysis showed that 2 variables, carcinoembryonic antigen (CEA) concentration > 30 ng/mL and a GPS 1 or 2, were independently prognostic of survival. Patients were classified into 3 groups on the basis of these 2 variables. Patients with GPS 1 or 2 and CEA concentration > 30 ng/mL were assigned a new score of 2, those with either 1 factor were assigned a new score of 1, and those with neither factors were assigned a new score of 0. The 5-year overall survival rates of new scores of 0, 1, 2 were 71.5%, 31.6%, and 0%, respectively (P < 0.0001).

CONCLUSIONS

This simple staging system may be able to identify a subgroup of patients who are eligible for curative resection but show poor prognosis.

摘要

背景/目的:关于基于炎症的格拉斯哥预后评分(GPS)的能力,人们了解甚少。

方法

对106例行结直肠癌肝转移(CRLM)根治性切除术的患者进行分析。入院时C反应蛋白浓度升高(>10mg/L)且白蛋白血症(<35g/L)的患者被分配为GPS 2,仅有其中一项生化异常的患者被分配为GPS 1,无任何异常的患者被分配为GPS 0。

结果

多变量分析显示,癌胚抗原(CEA)浓度>30ng/mL和GPS 1或2这两个变量独立预测生存。根据这两个变量将患者分为3组。GPS 1或2且CEA浓度>30ng/mL的患者被分配新评分为2,有其中一个因素的患者被分配新评分为1,无这两个因素的患者被分配新评分为0。新评分0、1、2的5年总生存率分别为71.5%、31.6%和0%(P<0.0001)。

结论

这个简单的分期系统或许能够识别出适合根治性切除但预后较差的患者亚组。

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