Galizia Gennaro, Lieto Eva, Auricchio Annamaria, Cardella Francesca, Mabilia Andrea, Podzemny Vlasta, Castellano Paolo, Orditura Michele, Napolitano Vincenzo
1 Division of GI Tract Surgical Oncology, Department of Surgical Sciences, University of Campania Luigi Vanvitelli, School of Medicine, Naples, Italy 2 Division of Medical Oncology, F. Magrassi Department of Clinical and Experimental Medicine, School of Medicine, Naples, Italy.
Dis Colon Rectum. 2017 Dec;60(12):1273-1284. doi: 10.1097/DCR.0000000000000961.
The existing scores reflecting the patient's nutritional and inflammatory status do not include all biomarkers and have been poorly studied in colorectal cancers.
The purpose of this study was to assess a new prognostic tool, the Naples prognostic score, comparing it with the prognostic nutritional index, controlling nutritional status score, and systemic inflammation score.
This was an analysis of patients undergoing surgery for colorectal cancer.
The study was conducted at a university hospital.
A total of 562 patients who underwent surgery for colorectal cancer in July 2004 through June 2014 and 468 patients undergoing potentially curative surgery were included. MaxStat analysis dichotomized neutrophil:lymphocyte ratio, lymphocyte:monocyte ratio, prognostic nutritional index, and the controlling nutritional status score. The Naples prognostic scores were divided into 3 groups (group 0, 1, and 2). The receiver operating characteristic curve for censored survival data compared the prognostic performance of the scoring systems.
Overall survival and complication rates in all patients, as well as recurrence and disease-free survival rates in radically resected patients, were measured.
The Naples prognostic score correlated positively with the other scoring systems (p < 0.001) and worsened with advanced tumor stages (p < 0.001). Patients with the worst Naples prognostic score experienced more postoperative complications (all patients, p = 0.010; radically resected patients, p = 0.026). Compared with group 0, patients in groups 1 and 2 had worse overall (group 1, HR = 2.90; group 2, HR = 8.01; p < 0.001) and disease-free survival rates (group 1, HR = 2.57; group 2, HR = 6.95; p < 0.001). Only the Naples prognostic score was an independent significant predictor of overall (HR = 2.0; p = 0.03) and disease-free survival rates (HR = 2.6; p = 0.01). The receiver operating characteristic curve analysis showed that the Naples prognostic score had the best prognostic performance and discriminatory power for overall (p = 0.02) and disease-free survival (p = 0.04).
This is a single-center study, and its validity needs additional external validation.
The Naples prognostic score is a simple tool strongly associated with long-term outcome in patients undergoing surgery for colorectal cancer. See Video Abstract at http://links.lww.com/DCR/A469.
现有的反映患者营养和炎症状态的评分未涵盖所有生物标志物，且在结直肠癌中的研究较少。
本研究旨在评估一种新的预后工具——那不勒斯预后评分，并将其与预后营养指数、控制营养状态评分和全身炎症评分进行比较。
这是一项对接受结直肠癌手术患者的分析。
该研究在一家大学医院进行。
纳入了2004年7月至2014年6月期间接受结直肠癌手术的562例患者以及468例接受潜在根治性手术的患者。MaxStat分析将中性粒细胞与淋巴细胞比率、淋巴细胞与单核细胞比率、预后营养指数和控制营养状态评分进行二分法划分。那不勒斯预后评分分为3组（0组、1组和2组）。针对删失生存数据的受试者工作特征曲线比较了各评分系统的预后性能。
测量所有患者的总生存率和并发症发生率，以及根治性切除患者的复发率和无病生存率。
那不勒斯预后评分与其他评分系统呈正相关（p < 0.001），并随肿瘤分期进展而恶化（p < 0.001）。那不勒斯预后评分最差的患者术后并发症更多（所有患者，p = 0.010；根治性切除患者，p = 0.026）。与0组相比，1组和2组患者的总生存率（1组，HR = 2.90；2组，HR = 8.01；p < 0.001）和无病生存率（1组，HR = 2.57；2组，HR = 6.95；p < 0.001）更差。只有那不勒斯预后评分是总生存率（HR = 2.0；p = 0.03）和无病生存率（HR = 2.6；p = 0.01）的独立显著预测因素。受试者工作特征曲线分析表明，那不勒斯预后评分在总生存（p = 0.02）和无病生存（p = 0.04）方面具有最佳的预后性能和鉴别能力。
这是一项单中心研究，其有效性需要额外的外部验证。
那不勒斯预后评分是一种简单的工具，与接受结直肠癌手术患者的长期预后密切相关。见视频摘要：http://links.lww.com/DCR/A469。
