术前高敏改良格拉斯哥预后评分对晚期结肠癌预后的预测价值：一项回顾性观察研究。
Prognostic value of preoperative high-sensitivity modified Glasgow prognostic score in advanced colon cancer: a retrospective observational study.
机构信息
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
出版信息
BMC Cancer. 2022 Jan 3;22(1):20. doi: 10.1186/s12885-021-09113-8.
BACKGROUND
Several studies have demonstrated that the preoperative Glasgow prognostic score (GPS) and modified GPS (mGPS) reflected the prognosis in patients undergoing curative surgery for colorectal cancer. However, there are no reports on long-term prognosis prediction using high-sensitivity mGPS (HS-GPS) in colorectal cancer. Therefore, this study aimed to calculate the prognostic value of preoperative HS-GPS in patients with colon cancer.
METHODS
A cohort of 595 patients with advanced resectable colon cancer managed at our institution was analysed retrospectively. HS-GPS, GPS, and mGPS were evaluated for their ability to predict prognosis based on overall survival (OS) and recurrence-free survival (RFS).
RESULTS
In the univariate analysis, HS-GPS was able to predict the prognosis with significant differences in OS but was not superior in assessing RFS. In the multivariate analysis of the HS-GPS model, age, pT, pN, and HS-GPS of 2 compared to HS-GPS of 0 (2 vs 0; hazard ratio [HR], 2.638; 95% confidence interval [CI], 1.046-6.650; P = 0.04) were identified as independent prognostic predictors of OS. In the multivariate analysis of the GPS model, GPS 2 vs 0 (HR, 1.444; 95% CI, 1.018-2.048; P = 0.04) and GPS 2 vs 1 (HR, 2.933; 95% CI, 1.209-7.144; P = 0.017), and in that of the mGPS model, mGPS 2 vs 0 (HR, 1.51; 95% CI, 1.066-2.140; P = 0.02) were independent prognostic predictors of OS. In each classification, GPS outperformed HS-GPS in predicting OS with a significant difference in the area under the receiver operating characteristic curve. In the multivariate analysis of the GPS model, GPS 2 vs 0 (HR, 1.537; 95% CI, 1.190-1.987; P = 0.002), and in that of the mGPS model, pN, CEA were independent prognostic predictors of RFS.
CONCLUSION
HS-GPS is useful for predicting the prognosis of resectable advanced colon cancer. However, GPS may be more useful than HS-GPS as a prognostic model for advanced colon cancer.
背景
多项研究表明，术前格拉斯哥预后评分（GPS）和改良 GPS（mGPS）反映了接受结直肠癌根治性手术患者的预后。然而，目前尚无关于使用高敏 mGPS（HS-GPS）预测结直肠癌长期预后的报道。因此，本研究旨在计算术前 HS-GPS 在结肠癌患者中的预后价值。
方法
回顾性分析了我院收治的 595 例晚期可切除结肠癌患者的队列。根据总生存（OS）和无复发生存（RFS），评估 HS-GPS、GPS 和 mGPS 预测预后的能力。
结果
单因素分析显示，HS-GPS 能显著预测 OS 预后，但在评估 RFS 方面并不优于其他指标。在 HS-GPS 模型的多因素分析中，年龄、pT、pN 和 HS-GPS 为 2 分与 HS-GPS 为 0 分（2 分比 0 分；HR，2.638；95%CI，1.046-6.650；P=0.04）被确定为 OS 的独立预后预测因子。在 GPS 模型的多因素分析中，GPS 为 2 分比 0 分（HR，1.444；95%CI，1.018-2.048；P=0.04）和 GPS 为 2 分比 1 分（HR，2.933；95%CI，1.209-7.144；P=0.017），mGPS 模型中，mGPS 为 2 分比 0 分（HR，1.51；95%CI，1.066-2.140；P=0.02），是 OS 的独立预后预测因子。在每个分类中，GPS 在预测 OS 方面优于 HS-GPS，ROC 曲线下面积的差异有统计学意义。在 GPS 模型的多因素分析中，GPS 为 2 分比 0 分（HR，1.537；95%CI，1.190-1.987；P=0.002），mGPS 模型中，pN、CEA 是 RFS 的独立预后预测因子。
结论
HS-GPS 可用于预测可切除晚期结肠癌的预后。然而，GPS 可能比 HS-GPS 更适合作为晚期结肠癌的预后模型。
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