Xiong Jianping, Hu Haitao, Kang Wenzhe, Li Yang, Jin Peng, Shao Xinxin, Li Weikun, Tian Yantao
Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Nutr. 2022 Jun 6;9:910271. doi: 10.3389/fnut.2022.910271. eCollection 2022.
This study focused on assessing the role of the Peking prognostic score (PPS), a novel prognostic index based on muscle atrophy and lymphocyte-to-C-reactive protein ratio, within gastric cancer patient prognosis.
We analyzed the data collected from 774 gastric cancer cases between April 2011 and February 2016 (discovery cohort). The results were assessed in 575 gastric cancer cases from March 2016 to September 2019 (validation cohort). For evaluating skeletal muscle mass, we obtained computed tomography images at the third lumbar vertebra level (L3). We performed a time-dependent receiver operating characteristic curve (t-ROC) to analyze PPS's prognostic significance with others.
The discovery cohort enrolled altogether 774 patients with non-metastatic gastric cancer, including 639 (82.5%) men along with 135 (17.5%) women. The patients were divided into 3 groups; 166 patients (21.4%) were assigned into group 0, 472 (60.9%) in group 1, and 136 (17.7%) in group 2, respectively. An increased PPS was in direct proportion to an elder age, reduced body mass index, higher Pathological Tumor Lymph Node Metastasis stage, perineural invasion, and vascular invasion. We identified PPS to independently estimate patient overall survival (OS) together with disease-free survival (DFS; both < 0.001). Additionally, as revealed by t-ROC analysis, PPS exhibited the highest sensitivity compared with other prognostic scoring systems in predicting patient survival. Finally, we evaluated the prognostic value of PPS in the validation cohort and confirmed that preoperative PPS independently estimates patient OS and DFS.
The PPS accounts for an efficient nutrition-inflammation prognostic scoring system in gastric cancer patients.
本研究聚焦于评估基于肌肉萎缩和淋巴细胞与C反应蛋白比值的新型预后指标——北京预后评分（PPS）在胃癌患者预后中的作用。
我们分析了2011年4月至2016年2月期间收集的774例胃癌病例的数据（发现队列）。结果在2016年3月至2019年9月期间的575例胃癌病例中进行评估（验证队列）。为评估骨骼肌质量，我们获取了第三腰椎水平（L3）的计算机断层扫描图像。我们进行了时间依赖性受试者工作特征曲线（t-ROC）分析，以分析PPS与其他指标相比的预后意义。
发现队列共纳入774例非转移性胃癌患者，其中男性639例（82.5%），女性135例（17.5%）。患者分为3组；分别有166例患者（21.4%）被分配到0组，472例（60.9%）在1组，136例（17.7%）在2组。PPS升高与年龄增大、体重指数降低、病理肿瘤淋巴结转移分期较高、神经周围侵犯和血管侵犯直接相关。我们确定PPS可独立评估患者的总生存期（OS）和无病生存期（DFS；均P<0.001）。此外，t-ROC分析显示，与其他预后评分系统相比，PPS在预测患者生存方面表现出最高的敏感性。最后，我们评估了PPS在验证队列中的预后价值，并证实术前PPS可独立评估患者的OS和DFS。
PPS是一种有效的胃癌患者营养-炎症预后评分系统。
