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口腔鳞状细胞癌根治性切除患者的全身炎症反应与生存情况

Systemic inflammatory response and survival in patients undergoing curative resection of oral squamous cell carcinoma.

作者信息

Farhan-Alanie O M, McMahon J, McMillan D C

机构信息

Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow G31 2ER, United Kingdom.

Department of Maxillofacial Surgery, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, United Kingdom.

出版信息

Br J Oral Maxillofac Surg. 2015 Feb;53(2):126-31. doi: 10.1016/j.bjoms.2014.10.007. Epub 2014 Nov 29.

Abstract

Prognostic stratification in squamous cell carcinoma (SCC) of the head and neck has traditionally relied on the pathological staging of a tumour, but it is increasingly being recognised that host-related factors have an important role in the assessment of survival and recurrence. We aimed to evaluate the prognostic value of systemic inflammation scores including the modified Glasgow Prognostic Score (mGPS) in patients undergoing potentially curative resection for oral SCC. We retrospectively identified 178 patients who had curative operations for cancer of the oral cavity and soft palate between January 2006 and April 2011. Among the inclusion criteria were preoperative estimates of C-reactive protein and serum albumin. We analysed established pathological prognostic factors and scores for systemic inflammation as predictors of cancer-specific and overall survival. On univariate analysis, the mGPS was a significant predictor of both cancer-specific (p<0.001) and overall survival (p<0.001), and it remained an independent predictor of cancer-specific (HR: 2.12, 95% CI 1.49 to 3.00; p<0.001) and overall survival (HR: 1.69, 95% CI 1.23 to 2.31; p=0.001) on Cox regression analysis. The mGPS of activated systemic inflammation seems to be a powerful adverse prognostic indicator in resectable oral SCC.

摘要

头颈部鳞状细胞癌(SCC)的预后分层传统上依赖于肿瘤的病理分期,但人们越来越认识到宿主相关因素在生存和复发评估中起着重要作用。我们旨在评估包括改良格拉斯哥预后评分(mGPS)在内的全身炎症评分在接受口腔SCC根治性切除术患者中的预后价值。我们回顾性确定了2006年1月至2011年4月间178例行口腔癌和软腭癌根治性手术的患者。纳入标准包括术前C反应蛋白和血清白蛋白的评估。我们分析了既定的病理预后因素和全身炎症评分作为癌症特异性生存和总生存的预测指标。单因素分析显示,mGPS是癌症特异性生存(p<0.001)和总生存(p<0.001)的显著预测指标,在Cox回归分析中,它仍然是癌症特异性生存(HR:2.12,95%CI 1.49至3.00;p<0.001)和总生存(HR:1.69,95%CI 1.23至2.31;p=0.001)的独立预测指标。激活的全身炎症的mGPS似乎是可切除口腔SCC中一个强大的不良预后指标。

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