Zhang Xiaojun, Gu Mengxuan, Zhu Jiahao, Gu Ruike, Yang Bo, Ji Shengjun, Zhao Yutian, Gu Ke
Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, China.
Wuxi School of Medicine, Jiangnan University, Wuxi, China.
Biomol Biomed. 2025 Apr 3;25(5):986-999. doi: 10.17305/bb.2024.10989.
This study aimed to investigate the prognostic value of the Naples Prognostic Score (NPS) in patients with locally advanced cervical cancer (LACC) who received curative concurrent chemoradiotherapy (CCRT). Clinicopathological data from 213 (training set) and 106 (validation set) LACC cases undergoing CCRT were retrospectively analyzed. The receiver operating characteristic curve (ROC) was used to compare the predictive ability of NPS and other indicators for survival. Cox proportional hazard regression was conducted for overall survival (OS) and progression-free survival (PFS). A prediction model using a nomogram was developed with independent prognostic factors in the training set and validated in the validation set. The 5-year OS for the NPS = 1, 2, and 3 groups was 56.8%, 45.4%, and 28.9% (P < 0.001), and the 5-year PFS for the NPS = 1, 2, and 3 groups was 44.9%, 36.7%, and 28.4% (P = 0.001), respectively. NPS showed better predictive ability for OS and PFS compared to other indicators. Multivariate regression analysis identified NPS as an independent prognostic factor for OS (P < 0.001) and PFS (P < 0.001). A predictive nomogram based on NPS was established and validated. The C-indices of the nomogram in the training set were 0.722 for OS and 0.683 for PFS, while in the validation set the C-indices were 0.731 for OS and 0.693 for PFS. This study confirmed that preoperative NPS could serve as a useful independent prognostic factor in LACC patients treated with CCRT.
本研究旨在探讨那不勒斯预后评分（NPS）在接受根治性同步放化疗（CCRT）的局部晚期宫颈癌（LACC）患者中的预后价值。对213例（训练集）和106例（验证集）接受CCRT的LACC病例的临床病理数据进行回顾性分析。采用受试者工作特征曲线（ROC）比较NPS和其他指标对生存的预测能力。对总生存（OS）和无进展生存（PFS）进行Cox比例风险回归分析。利用训练集中的独立预后因素建立了列线图预测模型，并在验证集中进行验证。NPS = 1、2和3组的5年总生存率分别为56.8%、45.4%和28.9%（P < 0.001），NPS = 1、2和3组的5年无进展生存率分别为44.9%、36.7%和28.4%（P = 0.001）。与其他指标相比，NPS对OS和PFS显示出更好的预测能力。多因素回归分析确定NPS是OS（P < 0.001）和PFS（P < 0.001）的独立预后因素。建立并验证了基于NPS的预测列线图。训练集中列线图的OS和PFS的C指数分别为0.722和0.683，而在验证集中，OS和PFS的C指数分别为0.731和0.693。本研究证实，术前NPS可作为接受CCRT治疗的LACC患者有用的独立预后因素。
