胃癌患者的绝对单核细胞和淋巴细胞计数预后评分
Absolute monocyte and lymphocyte count prognostic score for patients with gastric cancer.
作者信息
Eo Wan Kyu, Jeong Da Wun, Chang Hye Jung, Won Kyu Yeoun, Choi Sung Il, Kim Se Hyun, Chun Sung Wook, Oh Young Lim, Lee Tae Hwa, Kim Young Ok, Kim Ki Hyung, Ji Yong Il, Kim Ari, Kim Heung Yeol
机构信息
Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
出版信息
World J Gastroenterol. 2015 Mar 7;21(9):2668-76. doi: 10.3748/wjg.v21.i9.2668.
AIM
To measure the prognostic significance of absolute monocyte count/absolute lymphocyte count prognostic score (AMLPS) in patients with gastric cancer.
METHODS
We retrospectively examined the combination of absolute monocyte count (AMC) and absolute lymphocyte count (ALC) as prognostic variables in a cohort of 299 gastric cancer patients who underwent surgical resection between 2006 and 2013 and were followed at a single institution. Both AMC and ALC were dichotomized into two groups using cut-off points determined by receiving operator characteristic curve analysis. An AMLPS was generated, which stratified patients into three risk groups: low risk (both low AMC and high ALC), intermediate risk (either high AMC or low ALC), and high risk (both high AMC and low ALC). The primary objective of the study was to validate the impact of AMLPS on both disease-free survival (DFS) and overall survival (OS), and the second objective was to assess the AMLPS as an independent prognostic factor for survival in comparison with known prognostic factors.
RESULTS
Using data from the entire cohort, the most discriminative cut-off values of AMC and ALC selected on the receiver operating characteristic curve were 672.4/μL and 1734/μL for DFS and OS. AMLPS risk groups included 158 (52.8%) patients in the low-risk, 128 (42.8%) in the intermediate-risk, and 13 (4.3%) in the high-risk group. With a median follow-up of 37.2 mo (range: 1.7-91.4 mo), five-year DFS rates in the low-, intermediate-, and high-risk groups were 83.4%, 78.7%, and 19.8%, respectively. And five-year OS rates in the low-, intermediate-, and high-risk groups were 89.3%, 81.1%, and 14.4%, respectively. On multivariate analysis performed with patient- and tumor-related factors, we identified AMLPS, age, and pathologic tumor-node-metastasis stage as the most valuable prognostic factors impacting DFS and OS.
CONCLUSION
AMLPS identified patients with a poor DFS and OS, and it was independent of age, pathologic stage, and various inflammatory markers.
目的
评估绝对单核细胞计数/绝对淋巴细胞计数预后评分（AMLPS）在胃癌患者中的预后意义。
方法
我们回顾性研究了2006年至2013年间在单一机构接受手术切除并随访的299例胃癌患者队列中，将绝对单核细胞计数（AMC）和绝对淋巴细胞计数（ALC）作为预后变量的组合情况。通过接受者操作特征曲线分析确定的截断点，将AMC和ALC均分为两组。生成AMLPS，将患者分为三个风险组：低风险（AMC低且ALC高）、中风险（AMC高或ALC低）和高风险（AMC高且ALC低）。该研究的主要目的是验证AMLPS对无病生存期（DFS）和总生存期（OS）的影响，第二个目的是与已知预后因素相比，评估AMLPS作为生存的独立预后因素。
结果
使用整个队列的数据，在接受者操作特征曲线上选择的AMC和ALC最具鉴别力的截断值，对于DFS和OS分别为672.4/μL和1734/μL。AMLPS风险组中，低风险组有158例（52.8%）患者，中风险组有128例（42.8%）患者，高风险组有13例（4.3%）患者。中位随访时间为37.2个月（范围：1.7 - 91.4个月），低、中、高风险组的五年DFS率分别为83.4%、78.7%和19.8%。低、中、高风险组的五年OS率分别为89.3%、81.1%和14.4%。在对患者和肿瘤相关因素进行多变量分析时，我们确定AMLPS、年龄和病理肿瘤-淋巴结-转移分期是影响DFS和OS的最有价值的预后因素。
结论
AMLPS可识别出DFS和OS较差的患者，且其独立于年龄、病理分期和各种炎症标志物。
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