Department of Genitourinary, Sanaikai General Hospital (IMS), Japan.
Department of Genitourinary, Toho University Omori Medical Center, Japan.
Int Braz J Urol. 2019 May-Jun;45(3):541-548. doi: 10.1590/S1677-5538.IBJU.2018.0251.
To investigate whether Glasgow Prognostic Score has prognostic significance in patients with upper urinary urothelial carcinoma.
We retrospectively reviewed the clinical records of 74 patients with upper urinary urothelial carcinoma. We set the cut-off value for C-reactive protein as 1.0mg/dL, and 3.5mg/dL for albumin as Glasgow Prognostic Score. Their blood data including albumin and C-reactive protein for Glasgow Prognostic Score and cytokeratin 19 fragment 21-1 as a tumor marker were measured before starting treatment. The patients were stratified into three groups with Glasgow Prognostic Score: The Group-1, albumin ≥3.5g/dL and C-reactive protein < 1.0mg/dL; Group-2, albumin < 3.5g/dL or C-reactive protein ≥1.0mg/dL; Group-3, albumin < 3.5g/dL and C-reactive protein ≥1.0mg/dL.
The median follow-up for all patients was 26.9 months (range: 10.9-91.1 months), during which 37 (50%) patients died. There was a signifi cant difference in the estimated survival rate among the 3 groups stratified by Glasgow Prognostic Score. The estimated survival rate in the Group-1 was significantly higher than those in Groups 2 and 3. In the univariate analysis C-reactive protein, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were significant predictors of overall survival. On the multivariate analysis, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were independently associated with shorter overall survival.
Our review suggests Glasgow Prognostic Score may play as a prognostic predictor for upper urinary urothelial carcinoma.
探讨格拉斯哥预后评分(Glasgow Prognostic Score,GPS)在上尿路尿路上皮癌患者中的预后意义。
我们回顾性分析了 74 例上尿路尿路上皮癌患者的临床资料。我们将 C-反应蛋白的截断值设为 1.0mg/dL,白蛋白的截断值设为 3.5mg/dL,作为 GPS。在开始治疗前,测量了包括白蛋白和 C-反应蛋白(用于 GPS)以及细胞角蛋白 19 片段 21-1(一种肿瘤标志物)在内的血液数据。根据 GPS 将患者分为三组:组 1,白蛋白≥3.5g/dL 且 C-反应蛋白<1.0mg/dL;组 2,白蛋白<3.5g/dL 或 C-反应蛋白≥1.0mg/dL;组 3,白蛋白<3.5g/dL 且 C-反应蛋白≥1.0mg/dL。
所有患者的中位随访时间为 26.9 个月(范围:10.9-91.1 个月),其中 37 例(50%)患者死亡。根据 GPS 分层的 3 组患者的估计生存率存在显著差异。组 1 的估计生存率明显高于组 2 和组 3。单因素分析显示,C-反应蛋白、血清细胞角蛋白 19 片段 21-1 和 GPS 是总生存期的显著预测因子。多因素分析显示,血清细胞角蛋白 19 片段 21-1 和 GPS 与总生存期较短独立相关。
我们的研究表明,GPS 可能对上尿路尿路上皮癌的预后具有预测作用。