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在有靶向突变的晚期肺癌中,预后营养指数和改良格拉斯哥预后评分的预后重要性。

Prognostic importance of prognostic nutritional index and modified Glasgow prognostic score in advanced lung cancer with targetable mutation.

机构信息

Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University, Cankaya, 06800, Ankara, Turkey.

Department of Internal Medicine, Erzurum Regional Education and Research Hospital, Erzurum, Turkey.

出版信息

J Cancer Res Clin Oncol. 2024 Apr 26;150(4):215. doi: 10.1007/s00432-023-05529-w.

Abstract

BACKGROUND

Inflammation and nutrition are important parameters that significantly affect survival in various malignancies. Prognostic nutritional index (PNI) and modified Glasgow prognostic score (mGPS) can reflect both inflammatory and nutritional conditions. Therefore, we aimed to evaluate the prognostic value of PNI and mGPS in patients who had the targetable mutation and also received targeted therapy.

MATERIALS AND METHODS

Advanced lung cancer patients with EGFR mutation (mut) and ALK rearrangement were enrolled to study, retrospectively. PNI has with the following formula: 10 × serum albumin (g/dl) + 0.005 × peripheral lymphocyte count (per mm) and threshold value was accepted as 50. Modified GPS was also calculated using albumin and CRP level and patients were scored as range 0 to 2.

RESULTS

A total of 182 patients enrolled in the study. 132 and 50 of 182 patients had EGFR mut and ALK rearrangement, respectively. PFS was significantly longer in high PNI group in both the EGFR and ALK rearrangement-positive subgroups (P = 0.004 for EGFR mut-positive group; P = 0.017 for ALK rearrangement-positive group). Additionally, PFS was significantly shortened from mGPS 0 to 2 (P =  < 0.001 for EGFR mut-positive group; P = 0.016 for ALK rearrangement-positive group).

CONCLUSION

Both PNI and mGPS can be used as a reliable, inexpensive, and easily applicable prognostic index in the advanced lung cancer patients who had the targetable mutation and also received targeted therapy.

摘要

背景

炎症和营养是影响多种恶性肿瘤患者生存的重要因素。预后营养指数(PNI)和改良格拉斯哥预后评分(mGPS)可反映炎症和营养状况。因此,我们旨在评估 PNI 和 mGPS 在具有可靶向突变并接受靶向治疗的患者中的预后价值。

材料和方法

回顾性纳入晚期肺癌患者,这些患者具有 EGFR 突变(mut)和 ALK 重排。PNI 采用以下公式计算:血清白蛋白(g/dl)×10+外周血淋巴细胞计数(per mm)×0.005,阈值接受为 50。改良 GPS 也根据白蛋白和 CRP 水平计算,患者的评分范围为 0 到 2。

结果

本研究共纳入 182 例患者。182 例患者中,有 132 例和 50 例分别为 EGFR mut 和 ALK 重排阳性。在 EGFR mut 阳性亚组和 ALK 重排阳性亚组中,高 PNI 组的 PFS 明显更长(P=0.004 用于 EGFR mut 阳性组;P=0.017 用于 ALK 重排阳性组)。此外,mGPS 从 0 到 2 时 PFS 明显缩短(P= <0.001 用于 EGFR mut 阳性组;P=0.016 用于 ALK 重排阳性组)。

结论

在具有可靶向突变并接受靶向治疗的晚期肺癌患者中,PNI 和 mGPS 均可作为可靠、经济且易于应用的预后指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d0/11052844/5c2d7054d8f8/432_2023_5529_Fig1_HTML.jpg

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