Pan Qun-Xiong, Su Zi-Jian, Zhang Jian-Hua, Wang Chong-Ren, Ke Shao-Ying
Department of Oncological Surgery, Quanzhou First Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, P.R. China.
Mol Clin Oncol. 2017 Apr;6(4):566-574. doi: 10.3892/mco.2017.1166. Epub 2017 Feb 16.
High Glasgow Prognostic Score (GPS) has been associated with poor prognosis in patients with lung, ovarian, colorectal and renal cancer, as well as hepatocellular carcinoma. The aim of this study was to investigate the prognostic value of GPS in patients with intrahepatic cholangiocarcinoma (ICC) undergoing partial hepatectomy. A total of 72 patients with pathologically confirmed ICC were classified according to their GPS scores assigned based on the preoperative levels of C-reactive protein (CRP) and albumin. Their clinicopathological data were retrospectively assessed using univariate and multivariate analysis to determine their association with overall survival and recurrence. High GPS scores in ICC patients were associated with preoperative levels of CRP (P<0.001) and albumin (P<0.001), frequency of ascites accumulation (P=0.035), lymph node metastasis (P=0.002) and tumour size (P=0.005). On univariate analysis, preoperative levels of CRP (P<0.001), albumin (P=0.016) and carbohydrate antigen 19-9 (P=0.038), hepatitis B virus (HBV) positivity (P=0.009), occurrence of lymph node metastasis (P=0.001), Child-Pugh class B (P=0.013) and high tumour-node-metastasis (TNM) stage (P=0.002) were found to be associated with the 1- and 3-year overall survival. Multivariate analysis suggested that GPS score (HR=2.037, 95% CI: 1.092-3.799, P=0.025), TNM classification (HR=2.000, 95% CI: 1.188-3.367, P=0.009) and HBV positivity (HR=0.559 95% CI: 0.328-0.953, P=0.032) were independently associated with patient survival. High GPS scores also predicted ICC recurrence. In conclusion, our results demonstrated that GPS may serve as an independent marker of prognosis in patients with ICC following partial hepatectomy.
高格拉斯哥预后评分（GPS）与肺癌、卵巢癌、结直肠癌、肾癌以及肝细胞癌患者的不良预后相关。本研究旨在探讨GPS在接受肝部分切除术的肝内胆管癌（ICC）患者中的预后价值。根据术前C反应蛋白（CRP）和白蛋白水平为72例经病理确诊的ICC患者进行GPS评分并分类。采用单因素和多因素分析回顾性评估其临床病理数据，以确定它们与总生存期和复发的相关性。ICC患者的高GPS评分与术前CRP水平（P<0.001）、白蛋白水平（P<0.001）、腹水积聚频率（P=0.035）、淋巴结转移（P=0.002）和肿瘤大小（P=0.005）相关。单因素分析发现，术前CRP水平（P<0.001）、白蛋白水平（P=0.016）、糖类抗原19-9（P=0.038）、乙肝病毒（HBV）阳性（P=0.009）、淋巴结转移的发生（P=0.001）、Child-Pugh B级（P=0.013）和高肿瘤-淋巴结-转移（TNM）分期（P=0.002）与1年和3年总生存期相关。多因素分析表明，GPS评分（HR=2.037，95%CI：1.092-3.799，P=0.025）、TNM分类（HR=2.000，95%CI：1.188-3.367，P=0.009）和HBV阳性（HR=0.559，CI：0.328-0.953，P=0.032）与患者生存独立相关。高GPS评分也可预测ICC复发。总之，我们的结果表明，GPS可能是肝部分切除术后ICC患者预后的独立标志物。
