Ando Keisuke, Sakamoto Shinichi, Saito Shinpei, Maimaiti Maihulan, Imamura Yusuke, Sazuka Tomokazu, Sato Nobuo, Komiya Akira, Anzai Naohiko, Ichikawa Tomohiko
Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan.
Department of Pathology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan.
Cancers (Basel). 2021 Feb 12;13(4):773. doi: 10.3390/cancers13040773.
The Glasgow prognostic score, a marker of systemic inflammation, is associated with clinical outcomes in different cancers including prostate cancer. However, there is no evidence for the relationship between the high-sensitivity modified Glasgow prognostic score (Hs-mGPS) in prostate cancer and its prognosis. This study aimed to investigate the prognostic significance of Hs-mGPS in castration-resistant prostate cancer (CRPC) treated with docetaxel. We retrospectively analyzed clinical datasets from 131 CRPC patients who received docetaxel treatment at Chiba University Hospital and a related hospital. Clinical factors including Hs-mGPS before docetaxel treatment were evaluated according to overall survival. The numbers of patients with Hs-mGPS of 0, 1, and 2 were 88, 30, and 13, respectively. The median prostate-specific antigen (PSA) level was 28.9 ng/mL. The median testosterone level was 13.0 ng/dL. The percentages of bone and visceral metastases were 80.8% and 10.2%, respectively. For overall survival, Hs-mGPS ≥ 1 (hazard ratio of 2.41; = 0.0048), testosterone ≥ 13.0 ng/dL (hazard ratio of 2.23; = 0.0117), and PSA ≥ 28.9 ng/mL (hazard ratio of 2.36; = 0.0097) were significant poor prognostic factors in the multivariate analysis. The results of the two-group analysis showed that a higher Hs-mGPS was associated with high PSA, alkaline phosphatase, and testosterone levels. The median testosterone levels for Hs-mGPS of 0, 1, and 2 were 9.0, 16.5, and 23.0, respectively. Based on the multivariate analysis, we created a combined score with three prognostic factors: Hs-mGPS, testosterone, and PSA. The low-risk group (score of 0-1) showed a significantly longer overall survival compared to the intermediate-risk (score of 2-3) and high-risk (score of 4) groups ( < 0.0001). Our results demonstrated that an elevated Hs-mGPS was an independent prognostic factor in CRPC patients treated with docetaxel therapy. Risk classification based on Hs-mGPS, testosterone, and PSA may be useful in predicting the prognosis of CRPC patients.
格拉斯哥预后评分作为全身炎症的一个指标，与包括前列腺癌在内的不同癌症的临床结局相关。然而，目前尚无证据表明前列腺癌中高敏改良格拉斯哥预后评分（Hs-mGPS）与其预后之间存在关联。本研究旨在探讨Hs-mGPS在接受多西他赛治疗的去势抵抗性前列腺癌（CRPC）中的预后意义。我们回顾性分析了千叶大学医院及一家相关医院131例接受多西他赛治疗的CRPC患者的临床数据集。根据总生存期评估多西他赛治疗前包括Hs-mGPS在内的临床因素。Hs-mGPS为0、1和2的患者数量分别为88、30和13例。前列腺特异性抗原（PSA）水平中位数为28.9 ng/mL。睾酮水平中位数为13.0 ng/dL。骨转移和内脏转移的比例分别为80.8%和10.2%。在多因素分析中，Hs-mGPS≥1（风险比为2.41；P = 0.0048）、睾酮≥13.0 ng/dL（风险比为2.23；P = 0.0117）以及PSA≥28.9 ng/mL（风险比为2.36；P = 0.0097）是显著的不良预后因素。两组分析结果显示，较高的Hs-mGPS与较高的PSA、碱性磷酸酶和睾酮水平相关。Hs-mGPS为0、1和2时的睾酮水平中位数分别为9.0、16.5和23.0。基于多因素分析，我们创建了一个包含Hs-mGPS、睾酮和PSA三个预后因素的综合评分。低风险组（评分为0 - 1）与中风险组（评分为2 - 3）和高风险组（评分为4）相比，总生存期显著更长（P < 0.0001）。我们的结果表明，升高的Hs-mGPS是接受多西他赛治疗的CRPC患者的独立预后因素。基于Hs-mGPS、睾酮和PSA的风险分类可能有助于预测CRPC患者的预后。
