炎症标志物对无远处转移的阴茎鳞癌患者的预后价值。

Prognostic Value of Inflammation Biomarkers in Penile Squamous Cell Carcinoma Patients Without Distant Metastasis.

机构信息

Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, China; State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China; Collaborative Innovation Center of Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.

Department of Urology, Shenzhen People's Hospital, The Second Clinic Medical College of Jinan University, Shenzhen, China; Department of Urology, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China; Minimally Invasive Urology of Shenzhen Research and Development Center of Medical Engineering and Technology, Shenzhen People's Hospital, Shenzhen, China.

出版信息

Clin Genitourin Cancer. 2023 Oct;21(5):e334-e342.e1. doi: 10.1016/j.clgc.2023.03.014. Epub 2023 Apr 5.

DOI:10.1016/j.clgc.2023.03.014

PMID:37225533

Abstract

BACKGROUND

To investigate the value of the presurgical inflammatory biomarkers including C-reactive protein (CRP), albumin (ALB), C-reactive protein to albumin ratio (CAR), Glasgow prognostic score (GPS), the modified GPS (mGPS), and the high-sensitivity modified GPS (Hs-mGPS) in penile squamous cell carcinoma (PSCC) without distant metastasis and develop a tool to predict the overall survival (OS) of PSCC patients.

METHODS

We retrospectively enrolled 271 PSCC patients without distant metastasis from 2006 to 2021. Patients were divided into 2 cohorts by a 7:3 ratio-a training cohort (n = 191) and a validation cohort (n = 80). We performed cox regression analyses on the training cohort and constructed a nomogram to predict OS over 1, 3, and 5 years. Data from the validation cohort was used to validate the nomogram's predictive power.

RESULTS

According to Kaplan-Meier analysis, elevated CRP (P < .001), hypoalbuminemia (P = .008), higher CAR (P < .001), higher GPS score (P < .001), higher mGPS score (P < .001), and higher Hs-mGPS score (P = .015) were associated with a decreased overall survival. GPS score, along with age, pathology N stage, and grade, was found to be an independent risk factor for poor prognosis in the multivariate analysis. We constructed a nomogram based on the prespecified variables predicting 1-, 3- and 5-year OS. The C-indexes of the nomogram in the training and validation cohorts were 0.871 and 0.869, respectively. The decision curve analysis showed that the nomogram had a larger net benefit. The Kaplan-Meier curves showed significant differences between the risk groups categorized according to the nomogram (P < .001).

CONCLUSIONS

Inflammation biomarkers of systemic inflammation and nutritional status play an important role in individual OS predictions for PSCC patients without distant monitoring. The establishment of the nomogram provided a tool to predict the survival of 1-, 3-, and 5-year OS in PSCC patients without distant metastasis.

摘要

背景

探讨术前炎症标志物包括 C 反应蛋白（CRP）、白蛋白（ALB）、C 反应蛋白与白蛋白比值（CAR）、格拉斯哥预后评分（GPS）、改良 GPS（mGPS）和高敏改良 GPS（Hs-mGPS）在无远处转移的阴茎鳞癌（PSCC）中的价值，并建立预测 PSCC 患者总生存（OS）的工具。

方法

我们回顾性纳入了 2006 年至 2021 年间无远处转移的 271 例 PSCC 患者。患者按 7：3 比例分为训练队列（n=191）和验证队列（n=80）。我们在训练队列中进行 Cox 回归分析，并构建预测 1、3 和 5 年 OS 的列线图。验证队列的数据用于验证列线图的预测能力。

结果

根据 Kaplan-Meier 分析，升高的 CRP（P<0.001）、低白蛋白血症（P=0.008）、更高的 CAR（P<0.001）、更高的 GPS 评分（P<0.001）、更高的 mGPS 评分（P<0.001）和更高的 Hs-mGPS 评分（P=0.015）与总生存率降低相关。多因素分析显示，GPS 评分与年龄、病理 N 分期和分级一起是预后不良的独立危险因素。我们根据预测 1 年、3 年和 5 年 OS 的预设变量构建了一个列线图。列线图在训练和验证队列中的 C 指数分别为 0.871 和 0.869。决策曲线分析显示，该列线图具有更大的净获益。Kaplan-Meier 曲线显示，根据列线图分组的风险组之间存在显著差异（P<0.001）。