Yamada Suguru, Fujii Tsutomu, Yabusaki Norimitsu, Murotani Kenta, Iwata Naoki, Kanda Mitsuro, Tanaka Chie, Nakayama Goro, Sugimoto Hiroyuki, Koike Masahiko, Fujiwara Michitaka, Kodera Yasuhiro
From the Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine (SY, TF, NY, NI, MK, CT, GN, HS, MK, MF, YK), and Center for Advanced Medicine and Clinical Research (KM), Nagoya University Hospital, Aichi, Japan.
Medicine (Baltimore). 2016 May;95(18):e3582. doi: 10.1097/MD.0000000000003582.
A variety of systemic inflammation-based prognostic scores have been explored; however, there has been no study to clarify which score could best reflect survival in resected pancreatic cancer patients.Between 2002 and 2014, 379 consecutive patients who underwent curative resection of pancreatic cancer were enrolled. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), prognostic index (PI), and prognostic nutritional index (PNI) scores for each patient were calculated. Survival of each score was evaluated, and correlations between the score selected on the basis of the prognostic significance and various clinicopathological factors were analyzed.In the analysis of the GPS, the median survival time (MST) was 28.1 months for score 0, 25.6 for score 1, and 17.0 for score 2. As for mGPS, the MST was 25.8 months for score 0, 27.7 for score 1, and 17.0 for score 2. Both scores were found to be significant. On the contrary, there were no statistical differences in MST between various scores obtained using the NLR, PLR, PI, or PNI. Multivariate analysis revealed that lymph node metastasis, positive peritoneal washing cytology, and a GPS score of 2 were significant prognostic factors. There was also statistically significant correlation between the GPS score and tumor location (head), tumor size (≥2.0 cm), bile duct invasion, and duodenal invasion.Our study demonstrated that the GPS could be an independent predictive marker and was superior to other inflammation-based prognostic scores in patients with resected pancreatic cancer.
已经探索了多种基于全身炎症的预后评分；然而，尚无研究阐明哪种评分最能反映接受胰腺癌切除术患者的生存率。在2002年至2014年期间，连续纳入了379例行胰腺癌根治性切除术的患者。计算了每位患者的格拉斯哥预后评分（GPS）、改良GPS（mGPS）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、预后指数（PI）和预后营养指数（PNI）评分。评估了每个评分的生存率，并分析了基于预后意义选择的评分与各种临床病理因素之间的相关性。在GPS分析中，评分为0时的中位生存时间（MST）为28.1个月，评分为1时为25.6个月，评分为2时为17.0个月。至于mGPS，评分为0时的MST为25.8个月，评分为1时为27.7个月，评分为2时为17.0个月。发现这两种评分均具有显著性。相反，使用NLR、PLR、PI或PNI获得的不同评分之间MST没有统计学差异。多因素分析显示，淋巴结转移、阳性腹腔冲洗细胞学检查和GPS评分为2是显著的预后因素。GPS评分与肿瘤位置（胰头）、肿瘤大小（≥2.0 cm）、胆管侵犯和十二指肠侵犯之间也存在统计学显著相关性。我们的研究表明GPS可能是一个独立的预测标志物，并且在接受胰腺癌切除术的患者中优于其他基于炎症的预后评分。
