Cui Y, Li J, Cao Y H, Liu M Y, Shi Z X, Gao T H
Department of Oncology, Henan Provincial People's Hospital (Zhengzhou University People's Hospital), Zhengzhou, Henan 450003, China.
Department of General Surgery, Henan Cancer Hospital, Zhengzhou University, Zhengzhou, Henan 450008, China.
Zhonghua Zhong Liu Za Zhi. 2017 Mar 23;39(3):195-200. doi: 10.3760/cma.j.issn.0253-3766.2017.03.007.
To study the predictive and prognostic significance of high-sensitivity modified Glasgow Prognostic Score (HS-mGPS) on the effect of neoadjuvant chemotherapy for advanced gastric cancer. 117 patients with advanced gastric cancer received neoadjuvant chemotherapy with SOX (oxaliplatin+ S1) or mFOLFOX 6(oxaliplatin+ CF+ 5-FU) regimen. HS-mGPS was calculated according to blood C-reactive protein (CRP) concentration and serum albumin (ALB) level. The correlation between HS-mGPS and clinicopathological characteristics was determined and the predictors of survival were analyzed. 117 patients with stage ⅡB (43 cases), stage Ⅲ (60), and stage Ⅳ (14) received preoperative neoadjuvant chemotherapy. The overall response rate of neoadjuvant chemotherapy was 61.5%(72/117), and the tumor control rate was 88.0% (103/117), with a pathological response rate of 91.5% (107/117). The R0 resection rate was 81.2% (95/117). The median disease-free survival (DFS) was 21.0 (95% 6.4-35.6) months. The median overall survival (OS) was 39.0 (95% 21.4-56.6) months. Higher HS-mGPS was associated with higher T stage, local lymph-node metastasis, distant metastasis, lower chemotherapy overall response rate and lower pathological response rate (all <0.05). The univariate analysis and multivariate analysis showed that higher HS-mGPS, presence of local lymph-node metastasis and non R0 resection were associated with poorer DFS and OS (<0.05). HS-mGPS can be used to predict the benefits of neoadjuvant chemotherapy and as an independent prognostic factor for survival in patients with advanced gastric cancer.
研究高敏改良格拉斯哥预后评分（HS-mGPS）对晚期胃癌新辅助化疗疗效的预测及预后意义。117例晚期胃癌患者接受了以SOX（奥沙利铂+S1）或mFOLFOX 6（奥沙利铂+亚叶酸钙+5-氟尿嘧啶）方案进行的新辅助化疗。根据血C反应蛋白（CRP）浓度和血清白蛋白（ALB）水平计算HS-mGPS。确定HS-mGPS与临床病理特征之间的相关性，并分析生存的预测因素。117例ⅡB期（43例）、Ⅲ期（60例）和Ⅳ期（14例）患者接受了术前新辅助化疗。新辅助化疗的总有效率为61.5%（72/117），肿瘤控制率为88.0%（103/117），病理缓解率为91.5%（107/117）。R0切除率为81.2%（95/117）。中位无病生存期（DFS）为21.0（95% 6.4 - 35.6）个月。中位总生存期（OS）为39.0（95% 21.4 - 56.6）个月。较高的HS-mGPS与更高的T分期、局部淋巴结转移、远处转移、更低的化疗总有效率和更低的病理缓解率相关（均<0.05）。单因素分析和多因素分析显示，较高的HS-mGPS、存在局部淋巴结转移和非R0切除与较差的DFS和OS相关（<0.05）。HS-mGPS可用于预测新辅助化疗的获益情况，并作为晚期胃癌患者生存的独立预后因素。
