Otowa Yasunori, Nakamura Tetsu, Takiguchi Gosuke, Tomono Ayako, Yamamoto Masashi, Kanaji Shingo, Imanishi Tatsuya, Suzuki Satoshi, Tanaka Kenichi, Itoh Tomoo, Kakeji Yoshihiro
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
Dis Esophagus. 2016 Feb-Mar;29(2):146-51. doi: 10.1111/dote.12316. Epub 2014 Dec 17.
The inflammation-based modified Glasgow prognostic score (mGPS) has been shown to be a prognostic factor for esophageal cancer, but its changes in relation to neoadjuvant chemotherapy (NAC) have never been discussed. The purpose of this study was to evaluate the potential prognostic role of mGPS with regard to NAC. mGPS was evaluated on the basis of admission blood samples taken before chemotherapy and before surgery. Patients with elevated C-reactive protein (CRP) serum levels (>10 mg/L) and hypoalbuminemia (<35 g/L) were allocated a score of 2, patients with elevated CRP serum levels without hypoalbuminemia were allocated a score of 1, and patients with normal CRP serum levels with or without hypoalbuminemia were allocated a score of 0. A total of 100 patients with clinical stage II/III squamous cell esophageal cancer, who underwent NAC and esophagectomy between January 2007 and August 2012, were investigated. From the multivariate analysis, the grade of response to chemotherapy and post-NAC mGPS level was found to be independent prognostic factors. The overall survival rate was significantly higher in the conserved mGPS group than in the worse mGPS group (P = 0.030). Changes in mGPS during chemotherapy affected the prognosis of patients, and post-NAC mGPS is an independent prognostic factor in patients with clinical stage II/III thoracic esophageal squamous cell cancer.
基于炎症的改良格拉斯哥预后评分（mGPS）已被证明是食管癌的一个预后因素，但其与新辅助化疗（NAC）相关的变化从未被讨论过。本研究的目的是评估mGPS在NAC方面的潜在预后作用。mGPS是根据化疗前和手术前采集的入院血样进行评估的。血清C反应蛋白（CRP）水平升高（>10 mg/L）且伴有低白蛋白血症（<35 g/L）的患者得分为2分，血清CRP水平升高但无低白蛋白血症的患者得分为1分，血清CRP水平正常（无论有无低白蛋白血症）的患者得分为0分。对2007年1月至2012年8月期间接受NAC和食管切除术的100例临床II/III期食管鳞状细胞癌患者进行了调查。多因素分析显示，化疗反应程度和NAC后mGPS水平是独立的预后因素。mGPS维持不变的组的总生存率显著高于mGPS恶化的组（P = 0.030）。化疗期间mGPS的变化影响患者的预后，NAC后mGPS是临床II/III期胸段食管鳞状细胞癌患者的独立预后因素。
