Kobayashi Satoru, Matsumura Yuji, Karube Yoko, Nishihira Morimichi, Inoue Takashi, Araki Osamu, Maeda Sumiko, Chida Masayuki
Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Japan.
Department of Cardiothoracic Surgery, Dokkyo Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, 343-0845, Japan.
World J Surg. 2018 Jul;42(7):2143-2152. doi: 10.1007/s00268-017-4426-4.
Idiopathic interstitial pneumonias (IIPs) are associated with an increased risk of lung cancer. Glasgow prognostic score (GPS), which uses serum C-reactive protein (CRP) and albumin levels to indicate systemic inflammatory response and nutrition level, has been reported to be a predictor of overall survival in patients with various types of cancer. We evaluated the usefulness of GPS for prediction of survival of patients with both lung cancer and IIPs following a lung resection procedure.
Patients with IIPs who underwent lung cancer resection from January 2006 through December 2015 were investigated. Routine laboratory measurements, including serum CRP and albumin for determining GPS, were performed before the operation. Univariate and multivariate analyses with a COX proportional hazards regression model were used to identify independent risk factors for overall survival (OS), relapse-free survival (RFS), cancer-specific survival (CSS), and other disease-specific survival (ODSS).
A total of 135 patients underwent lung resection during the study period. Multivariate analysis selected sublobar resection (p = 0.035), UIP pattern (p = 0.025), and GPS of 1-2 (p = 0.042) as predictive factors associated with OS, while GPS of 1-2 (p = 0.039) was shown to be a predictive factor associated with RFS. Multivariate analysis also revealed pTNM (p < 0.001), usual interstitial pneumonia pattern (p = 0.006), and GPS of 2 (p = 0.003) as predictive factors associated with CSS, while univariate analysis indicated pTNM (p = 0.042), GPS of 1 (p = 0.044), and %DLCO (p = 0.038) as predictive factors associated with ODSS.
GPS is an independent prognostic factor of OS and RFS in lung cancer patients with IIPs undergoing a lung resection procedure. Furthermore, a GPS of 2 was found to be associated with CSS following lung cancer resection, while a score of 1 was associated with ODSS.
特发性间质性肺炎（IIP）与肺癌风险增加相关。格拉斯哥预后评分（GPS）使用血清C反应蛋白（CRP）和白蛋白水平来指示全身炎症反应和营养水平，据报道它是各类癌症患者总生存期的一个预测指标。我们评估了GPS对肺癌合并IIP患者肺切除术后生存情况预测的有效性。
对2006年1月至2015年12月期间接受肺癌切除术的IIP患者进行调查。术前进行常规实验室检测，包括用于确定GPS的血清CRP和白蛋白检测。采用COX比例风险回归模型进行单因素和多因素分析，以确定总生存期（OS）、无复发生存期（RFS）、癌症特异性生存期（CSS）和其他疾病特异性生存期（ODSS）的独立危险因素。
研究期间共有135例患者接受了肺切除术。多因素分析选择肺叶下切除（p = 0.035）、UIP模式（p = 0.025）和GPS为1 - 2（p = 0.042）作为与OS相关的预测因素，而GPS为1 - 2（p = 0.039）被证明是与RFS相关的预测因素。多因素分析还显示pTNM（p < 0.001）、普通间质性肺炎模式（p = 0.006）和GPS为2（p = 0.003）作为与CSS相关的预测因素，而单因素分析表明pTNM（p = 0.042）、GPS为1（p = 0.044）和%DLCO（p = 0.038）作为与ODSS相关的预测因素。
GPS是接受肺切除术的肺癌合并IIP患者OS和RFS的独立预后因素。此外，发现GPS为2与肺癌切除术后的CSS相关，而评分为1与ODSS相关。
