Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651, Dongfengdong Road, Guangzhou, 510060, China.
Department of Oncology, The First Affiliated Hospital of Sun Yat-sen University, 58, the 2nd Zhongshan Road, Guangzhou, 510080, China.
BMC Cancer. 2018 Nov 12;18(1):1102. doi: 10.1186/s12885-018-4842-3.
The modified Glasgow Prognostic Score (mGPS) and the neutrophil-to-lymphocyte ratio (NLR) are conventional inflammation-based scores for colorectal cancer (CRC). The systemic inflammation score (SIS) has been shown to be more informative than the mGPS in CRC. The albumin-NLR, composed of albumin and the NLR, can also be a candidate for a valuable inflammation score. However, about the utility of the mGPS, SIS, and albumin-NLR for CRC patients who have received radical resections remains unclear.
This study enrolled 877 CRC patients, who underwent radical surgical resection between January 1, 2007 and December 31, 2014. The prognostic values of the mGPS, SIS, and albumin-NLR were compared by the Kaplan-Meier survival analysis, multivariate Cox regression modelling, and the time-dependent receiver operating characteristic curve analysis (ROC).
In the Kaplan-Meier analysis, all three inflammation scores were significantly associated with overall survival (OS) in the group including all the patients (mGPS, p = 0.016; SIS, p < 0.001; albumin-NLR, p = 0.007) and in the left-sided colon tumour subgroup (mGPS, p = 0.029; SIS p = 0.0013; albumin-NLR, p = 0.001). In the right-sided colon tumour subgroup, only the albumin-NLR was associated with OS (p = 0.048). The albumin-NLR was the only independent prognostic factor of the three scores for OS in the multivariate survival analysis.
The albumin-NLR outperformed both the SIS and mGPS in predicting OS in CRC patients undergoing radical resection.
改良格拉斯哥预后评分（mGPS）和中性粒细胞与淋巴细胞比值（NLR）是结直肠癌（CRC）常用的炎症指标。已有研究表明，系统炎症评分（SIS）比 mGPS 更能提供信息。由白蛋白和 NLR 组成的白蛋白- NLR 也可能成为有价值的炎症评分指标。然而，关于 mGPS、SIS 和白蛋白- NLR 对接受根治性手术的 CRC 患者的作用仍不清楚。
本研究纳入了 877 例于 2007 年 1 月 1 日至 2014 年 12 月 31 日期间接受根治性手术的 CRC 患者。通过 Kaplan-Meier 生存分析、多变量 Cox 回归模型和时间依赖性接受者操作特征曲线（ROC）分析比较 mGPS、SIS 和白蛋白- NLR 的预后价值。
在 Kaplan-Meier 分析中，所有三种炎症评分在包括所有患者的组中（mGPS，p=0.016；SIS，p<0.001；白蛋白- NLR，p=0.007）和左侧结肠癌亚组（mGPS，p=0.029；SIS，p=0.0013；白蛋白- NLR，p=0.001）中均与总生存期（OS）显著相关。在右侧结肠癌亚组中，只有白蛋白- NLR 与 OS 相关（p=0.048）。在多变量生存分析中，白蛋白- NLR 是三种评分中唯一与 OS 相关的独立预后因素。
在接受根治性手术的 CRC 患者中，白蛋白- NLR 比 SIS 和 mGPS 更能预测 OS。
