Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Department of Anesthesiology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
Clin Chim Acta. 2020 Dec;511:81-89. doi: 10.1016/j.cca.2020.09.027. Epub 2020 Sep 28.
Systemic inflammation and interactions with host-tumor are currently identified as a hallmark of cancer. The purpose of this study was to assess the prognostic value of preoperative modified Glasgow Prognostic Score (mGPS), systemic inflammation score (SIS) and "lymphocyte C-reactive protein score" (LCS) in gastric cancer (GC) patients.
358 GC patients were enrolled in this retrospective study. Kaplan-Meier method, multivariate Cox regression analysis, time-dependent receiver operating characteristics analysis (ROC), concordance index (C-index), and Akaike information criterion (AIC) were applied for assessments of the prognostic values.
Preoperative increased mGPS, SIS and LCS were all significantly linked with unfavorable overall survival using the Kaplan-Meier method (P < 0.001). Multivariate analysis proved that SIS was the only independent indicator among these three scoring systems. At the 4th-month point postoperatively, the time-dependent ROC curves of SIS and LCS crossed the curve of mGPS and were consistently superior to that of mGPS thereafter. The model incorporating SIS had higher C-index and smaller AIC than did the model without SIS or the models with mGPS or LCS.
Preoperative SIS exceeded both the mGPS and LCS and was the most clinically promising and feasible prognostic scoring system for GC patients.
目前认为全身性炎症与宿主-肿瘤相互作用是癌症的一个标志。本研究旨在评估术前改良格拉斯哥预后评分(mGPS)、全身性炎症评分(SIS)和“淋巴细胞 C 反应蛋白评分”(LCS)在胃癌(GC)患者中的预后价值。
本回顾性研究纳入了 358 例 GC 患者。采用 Kaplan-Meier 方法、多变量 Cox 回归分析、时间依赖性接受者操作特征分析(ROC)、一致性指数(C 指数)和赤池信息量准则(AIC)评估预后价值。
术前升高的 mGPS、SIS 和 LCS 均与 Kaplan-Meier 方法的不良总生存率显著相关(P<0.001)。多变量分析证实 SIS 是这三种评分系统中唯一的独立指标。术后第 4 个月,SIS 和 LCS 的时间依赖性 ROC 曲线越过 mGPS 曲线,此后一直优于 mGPS。包含 SIS 的模型比不包含 SIS 的模型或包含 mGPS 或 LCS 的模型具有更高的 C 指数和更小的 AIC。
术前 SIS 优于 mGPS 和 LCS,是 GC 患者最有临床前景和可行性的预后评分系统。