Ikeguchi Masahide, Ashida Keigo, Saito Hiroaki
Hepatogastroenterology. 2015 Jun;62(140):859-62.
BACKGROUND/AIMS: Complete resection of tumors is possible after heavy chemotherapy in a few patients with unresectable colorectal cancer (UCRC). This study evaluated the ability of new prognostic score to identify such patients.
Four peripheral blood markers were evaluated in 50 patients diagnosed with UCRC at the time of patients' first visit to the hospital: C-reactive protein (CRP), albumin (ALB), neutrophil/lymphocyte ratio (NLR), and carcinoembryonic antigen (CEA). Each was scored +1 or 0 for that marker. For example, when patient shows CRP ≥ 1.0 mg/dL, ALB 3.5 g/dL, NLR ≥ 5, and CEA ≥ 10 ng/mL, his score is +4. Thus, patients' scores could range from 0 to +4.
The median survival time (MST) of the 15 patients with scores 0 and +1 was longer than that of the 35 with scores +2, +3, and +4 (35 vs. 6 months, P < 0.001). R0 operation after treatment was performed in 2 patients (4%) with score 0 and +1.
Our prognostic score is useful in selecting patients with UCRC who will survive.
背景/目的：在少数无法切除的结直肠癌（UCRC）患者中，强化化疗后有可能实现肿瘤的完全切除。本研究评估了一种新的预后评分系统识别这类患者的能力。
在50例初次就诊时被诊断为UCRC的患者中评估了四种外周血标志物：C反应蛋白（CRP）、白蛋白（ALB）、中性粒细胞/淋巴细胞比值（NLR）和癌胚抗原（CEA）。每种标志物得分为+1或0。例如，当患者CRP≥1.0mg/dL、ALB≤3.5g/dL、NLR≥5且CEA≥10ng/mL时，其得分为+4。因此，患者的得分范围为0至+4。
得分0和+1的15例患者的中位生存时间（MST）长于得分+2、+3和+4的35例患者（35个月对6个月，P<0.001）。得分0和+1的2例患者（4%）在治疗后进行了R0手术。
我们的预后评分系统有助于筛选出能存活的UCRC患者。
