Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Ann Thorac Cardiovasc Surg. 2021 Jun 20;27(3):151-163. doi: 10.5761/atcs.oa.20-00247. Epub 2021 Feb 3.
We report this propensity score matching (PSM) analysis to assess prognostic roles of preoperative gamma-glutamyl transpeptidase to platelet ratio (GPR) in video-assisted thoracoscopic (VATS) lobectomy for stage I-II non-small-cell lung cancer (NSCLC).
The PSM-based study conducted on our single-center prospectively collected database from January 2014 to August 2015 provided Kaplan-Meier survival analyses using the log-rank test to discriminate differences in overall survival (OS) and disease-free survival (DFS) between patients stratified by preoperative GPR.
Our study includes 379 patients diagnosed with operable primary stage I-II NSCLC. A GPR value at 0.16 was recognized as the optimal cutoff point for prognostic prediction. Both OS and DFS of patients with GPR ≥0.16 were significantly shortened when compared to those of patients with GPR <0.16. Patients with GPR ≥0.16 had significantly lower 5-year rates of OS and DFS than those of patients with GPR <0.16 (P <0.001). Significant associations between GPR and unfavorable survival still are validated in the PSM analysis. Multivariable Cox regression models on both the entire cohort and the PSM cohort consistently demonstrated that an elevated preoperative GPR could be an independent prognostic marker for both OS and DFS of resectable NSCLC.
GPR may be an effective and noninvasive prognostic biomarker in VATS lobectomy for surgically resectable NSCLC.
我们报告了这项倾向评分匹配(PSM)分析,以评估术前γ-谷氨酰转肽酶与血小板比值(GPR)在电视辅助胸腔镜(VATS)肺叶切除治疗 I-II 期非小细胞肺癌(NSCLC)中的预后作用。
我们在 2014 年 1 月至 2015 年 8 月期间进行的单中心前瞻性收集数据库的 PSM 研究,使用对数秩检验对 Kaplan-Meier 生存分析进行了分层,以区分根据术前 GPR 分层的患者的总生存率(OS)和无病生存率(DFS)之间的差异。
我们的研究包括 379 例诊断为可手术的 I-II 期原发性 NSCLC 患者。GPR 值为 0.16 被认为是预测预后的最佳截断点。与 GPR <0.16 的患者相比,GPR ≥0.16 的患者的 OS 和 DFS 明显缩短。GPR ≥0.16 的患者的 5 年 OS 和 DFS 率明显低于 GPR <0.16 的患者(P <0.001)。在 PSM 分析中,GPR 与不良生存之间仍存在显著关联。在整个队列和 PSM 队列的多变量 Cox 回归模型中,术前升高的 GPR 均可作为可切除 NSCLC 的 OS 和 DFS 的独立预后标志物。
GPR 可能是 VATS 肺叶切除治疗可手术 NSCLC 的一种有效且无创的预后生物标志物。